Vestibular Schwannoma
Vestibular schwannoma, also known as an acoustic neuroma, is a rare, non-cancerous tumour that develops on the vestibulocochlear nerve. This nerve connects the inner ear to the brain and controls hearing and balance. The tumour grows slowly and is usually benign but can press on surrounding nerves or brain structures as it enlarges.
The symptoms of a vestibular schwannoma depend on its size and location. Common symptoms include:
- Hearing loss: Gradual hearing loss in one ear, sometimes sudden
- Tinnitus: Ringing or buzzing in the affected ear
- Balance problems: Dizziness, unsteadiness, or difficulty walking
- Facial numbness or weakness: If the tumour presses on the facial nerve
- Headaches: Due to increased pressure in the brain, in larger tumours
What are the symptoms?
What are the causes and risk factors?
The exact cause of vestibular schwannoma is not always known. However, factors include:
Genetic mutations
Most cases are sporadic, but some are associated with a genetic condition called neurofibromatosis type 2 (NF2).
Age
Most cases occur in adults between 30 and 60 years old.
Family history
A family history of NF2 increases the risk.
What are the complications from the condition?
If left untreated, vestibular schwannomas can lead to:
- Severe hearing loss: In the affected ear, and sometimes both ears in NF2 cases
- Balance issues: Chronic dizziness and unsteadiness can affect daily life
- Facial nerve damage: Leading to numbness, weakness, or facial paralysis
- Brainstem compression: Large tumours can press on the brainstem, affecting vital functions and becoming life-threatening.
- Hydrocephalus: Increased pressure in the brain due to blocked fluid flow
How is it diagnosed?
Doctors use several tests to diagnose vestibular schwannomas:
- Hearing tests (audiometry): To assess the degree of hearing loss
- MRI: The most reliable test to detect tumours and determine their size and location.
- CT Scan: Used when MRI is unavailable, though less detailed.
- Balance tests: To evaluate any balance-related symptoms
- Genetic testing: May be done if neurofibromatosis type 2 is suspected
How is it treated?
Treatment depends on the size of the tumour, its growth rate, and the symptoms. Options include:
- Observation (Watchful Waiting): Small tumours that aren’t growing or causing significant symptoms may be monitored with regular MRI scans.
- Surgery: Removal of the tumour, often recommended for large or symptomatic tumours. Surgical approaches include:
- Microsurgery: To preserve hearing and minimize nerve damage.
- Radiation Therapy: Stereotactic radiosurgery (e.g., Gamma Knife) is a non-invasive procedure that uses focused radiation to stop tumour growth.
- Rehabilitation: Physical therapy to manage balance issues, and speech therapy for facial nerve recovery.
Frequently Asked Questions
Is vestibular schwannoma cancerous?
No, it is a benign (non-cancerous) tumour.
Can vestibular schwannomas cause total deafness?
Without treatment, the tumour can lead to complete hearing loss in the affected ear.
Is surgery always required?
Not always. Small, slow-growing tumours can often be monitored without immediate intervention.
Can it recur after treatment?
Recurrence is possible, especially if the tumour cannot be completely removed during surgery.
Is vestibular schwannoma life-threatening?
While the tumour is not cancerous, large untreated tumours can press on the brainstem, which can be life-threatening.
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