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Acoustic Neuroma

(Acoustic Neurinoma; Vestibular Schwannoma; Eighth Nerve Tumor)

by Lawrence R. Lustig, MD

An acoustic neuroma (more correctly known as a vestibular schwannoma) is a noncancerous (benign) tumor that originates in the cells that wrap around the vestibular nerve (Schwann cells).

These tumors arise from the vestibular (balance) nerve, which is near the cochlear (auditory) nerve. The cochlear nerve carries sound signals to the brain. Early symptoms include slowly progressing hearing loss in one ear (hence the historical name acoustic neuroma), noise in the ear (tinnitus), headache, a feeling of pressure or fullness in the ear, ear pain, and imbalance or unsteadiness when the person turns quickly. If the tumor grows larger and compresses other parts of the brain, such as the facial nerve or the trigeminal nerve, weakness and numbness of the face may result. Early diagnosis is based on a magnetic resonance imaging (MRI) scan and hearing tests.

Tumors are removed by surgery or radiation therapy. Surgery may be done using a microscope (microsurgery) to avoid damaging the facial nerve. Radiation therapy may be done using a very precise technique (called stereotactic radiosurgery) so that only the tumor is affected.

How Ear Disorders Affect the Facial Nerve

Because the facial nerve winds through the ear, disorders of the middle and inner ear can affect it. For example, herpes zoster of the ear may affect the facial nerve as well as the auditory nerve. The facial nerve then swells and presses against the opening in the skull that it passes through. The pressure on this nerve can cause temporary or permanent facial paralysis. Treatment depends on the disorder causing the problem.

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