Acoustic neuroma

• Acoustic neuroma is a benign tumour arising from the Schwann cells, most commonly involving the vestibular portion of the vestibulocochlear nerve (cranial nerve VIII).
• It’s a non-cancerous, slow-growing tumour.

• Idiopathic in most cases.
• Association with neurofibromatosis type II (NF2) – an autosomal dominant genetic condition.

• Unilateral: Usually sporadic.
• Bilateral: Often associated with NF2.

• Growth of tumour can compress surrounding structures including cranial nerves and brainstem.
• Can lead to hydrocephalus if cerebrospinal fluid flow is blocked.

• Hearing loss.
• Tinnitus.
• Vertigo or imbalance.

• Unilateral sensorineural hearing loss.
• Ataxia.
• Cranial nerve palsies (rare).

• Audiometry: Assessing the extent of hearing loss.
• Basic neurological examination.

Magnetic Resonance Imaging (MRI): The gold standard for diagnosis, can show the size and location of the tumour.

• Monitoring (watchful waiting).
• Symptomatic treatment (e.g., for vertigo).

• Surgical resection.
• Radiosurgery (e.g., Gamma Knife).

• Facial nerve damage leading to facial weakness or paralysis.
• Cerebrospinal fluid leakage.
• Hearing loss.
• Meningitis.

• Acoustic neuromas are typically slow-growing tumours that can lead to hearing loss, tinnitus, and balance issues.
• While benign, they can cause significant morbidity due to their location.
• Management can range from observation to surgical intervention, depending on the size, location, and symptoms.