acoustic schwannoma symptoms
Are you familiar with auditory nerve tumors? Do you know that auditory nerves can also develop tumors?
Yes, the auditory nerve is the nerve of the eighth pair out of twelve pairs of nerves that come out of your brain, and the tumor of this nerve is called acoustic neuroma by doctors.
This tumor is benign but can cause painful symptoms and problems for the affected person.
Do you know the clinical manifestations of acoustic neuroma tumor? How do we know that we have acoustic neuroma?
In the following, we will acquaint you with the signs and symptoms of acoustic neuroma.
In this article, we will introduce you to the symptoms of acoustic neuroma or vestibular schwannoma. These two equivalents are used interchangeably.
In the vestibular schwannoma, involvement of the equilibrium area of the ear nerve may be much greater and balance symptoms predominate. In acoustic neuroma, there is involvement in both the auditory and balance control sections, and symptoms will appear in both fields, but generally the use of both titles will be similar.
This tumor is also called vestibular schwannoma by doctors. It is not a malignant tumor and grows inside a nerve that extends from the inner ear to the brain. The auditory nerve consists of two parts, a part related to your sense of hearing and a part to maintain communication balance. However, the growth of this tumor is slow and by increasing its size, it can disturb both your sense of hearing and your balance.
So, the symptoms of acoustic neuroma tumor have a negative effect on both your hearing and your balance, and these effects will be due to the pressure on the nerve parts of your ear due to the growth tumor.
Doctors say that cells called schwann cells that cover the nerve grow and multiply, and cause this tumor.
It is said that in very rare cases, the tumor may grow rapidly and become so large that it puts pressure on the brain tissue and causes symptoms of pressure on that particular area of the brain.
There is a part inside the skull that is adjacent to the cerebellum and the pons. Doctors call this area CP angle or CAP. Tumors in this area will be very important. Acoustic neuroma is one of the CP angle tumors.
Epidemiology
Vestibular schwannoma is said to affect 1.2 people per 100,000 population in the United States each year.
In most cases, this tumor is unilateral.
Eight percent of all intracranial tumors are vestibular schwannomas.
The most common age of onset of symptoms and manifestations will be from thirty to sixty years old.
In general, vestibular schwannoma is a benign, noncancerous tumor of the middle-aged.
It is said that in adults, schwannomas, tumors resulting from the growth of Schwann cells covering the nerves, are the most common tumors of the peripheral nervous system.
Which groups are more likely to develop acoustic neuroma or vestibular schwannoma?
Researchers say there is a substance that inhibits the over-proliferation of Schwann cells.
The gene for this inhibitory protein is located on a part of our number 22. If a disorder occurs on human chromosome 22 where the body can no longer produce this inhibitory protein, Schwann cells will proliferate and cause schwannoma.
- The occurrence of a rare genetic disorder:
Chromosome 22 abnormality is the only known risk factor for vestibular schwannoma, doctors say. This disorder is present in a rare genetic syndrome called neurofibromatosis type 2, abbreviated as NF-2.
In type 2 neurofibromatosis, we see a distinctive feature, which is the appearance of noncancerous tumors on the auditory nerve balance, usually bilateral, and schwannomas can also affect the rest of the nerves.
If one of the person's parents has the gene, their children are 50 percent more likely to be infected.
However, only five percent of all cases of acoustic neuroma, or vestibular schwannoma, have NF-2.
And the cause of this tumor in other people is not known, in other words, in other words, the original cause of acoustic neuroma in most affected cases is unknown.
Let's see what are the symptoms of this tumor.
What are the manifestations of acoustic schwannoma tumor?
Symptoms of vestibular schwannoma or manifestations of acoustic neuroma
This tumor grows slowly and takes years to grow enough to cause symptoms.
The symptoms are usually mild and can take a long time to develop and take years.
The pressure of the enlarged tumor on the components of hearing and balance will be the cause of the symptoms.
As the tumor grows, it may put pressure on other nerves adjacent to it, or pressure on the grown tumor may be applied to the brain tissue, or the arteries adjacent to the tumor may be compressed.
As the tumor grows, the number and type of symptoms will increase and the previous symptoms will worsen.
Common symptoms of vestibular schwannoma or acoustic neuroma
First, let’s look at the common symptoms of vestibular schwannoma or acoustic neurinoma:
Vertigo
Loss of motor balance control
Ringing in the ears
Gradual hearing loss, although sometimes hearing loss occurs suddenly, in cases where the tumor is bilateral, hearing loss in one ear is usually more severe.
Symptoms less common:
Pressure on the facial nerve and numbness of part of the face and in rare cases loss of motor power in the facial muscles.
We said that this tumor is one of the tumors in a very sensitive area of the skull called the CP angel. The pons is the control point for many vital human functions. The respiratory center is located in the pons. If the tumor becomes large enough to put pressure on the pons, it can become life-threatening.
In what cases should we see a doctor?
So be careful and if you experience the following symptoms, be sure to see a doctor immediately:
If you feel an imbalance that gets worse over time.
Ear ringing
Hearing loss
Early diagnosis and treatment of acoustic neuroma, or vestibular schwannoma, can prevent the sometimes-serious consequences of this tumor.
What are the complications of not treating in time?
Without timely treatment, the following complications can occur:
- Loss of motor balance
- Hearing loss
- Ear ringing
- Facial numbness
- Loss of mobility of facial muscles
If the tumor grows too much and puts pressure on the pons, life is threatened. Also, as the tumor grows, the communication hole between the skull and the spine may be blocked and fluid around the brain cannot enter the space inside the spine. Intracranial pressure rises and hydrocephalus develops, and a large amount of fluid accumulated around the brain puts pressure on the brain tissue, and depending on the location of the brain injury, this pressure causes problems and symptoms.
Diplopia
Speech disorders
And…
Diagnosis of vestibular schwannoma
The first step is an accurate history as well as a hearing test.
In the early stages when the tumor is not growing much, it is difficult to diagnose acoustic neuroma because the symptoms are very minor.
Audiometry
MRI is used to confirm the diagnosis of this tumor.
The tumor is said to be visible on MRI when it reaches about one to two centimeters.
If for some reason the patient is unable to have an MRI, the doctor may use a CT scan, but the point is that small tumors will not be seen on the CT scan.
Treatment of vestibular schwannoma
In people with very small tumors and minor symptoms, the doctor will monitor the patient.
This procedure is performed on the elderly or people who for any reason cannot tolerate invasive treatment, such as radiotherapy and surgery.
Regular checkups are requested to monitor the patient's condition.
And
Hearing or audiometry and imaging will be repeated every six to twelve months.
If serial images show high tumor growth or pressure on nearby adjacent areas, or if symptoms worsen, other treatments are selected according to the condition.
The surgical technique will depend on the location of the tumor, the size of the tumor, and the hearing status of the patient.
The surgeon aims to remove the tumor with surgery will be:
Preservation of the auditory nerve
Preservation of facial nerve
And hearing preservation
In cases where the tumor is in very close proximity to nerves and vital structures, the tumor cannot be removed surgically. And after surgery hearing loss and imbalance and… may be exacerbated.
Complications of surgery is:
- Meningitis
- Ear ringing
- Headache
- Facial numbness
- Weakness of facial muscles
- Loss of hearing
- Stroke
- Cerebral hemorrhage
And…
A type of radiotherapy called stereotactic radiosurgery is used to remove tumors under three centimeters and also to treat them in the elderly, and radiotherapy rays are irradiated directly into the tumor.
Stereotactic radiation therapy kills the tumor in a few sessions by irradiating a small amount of radiation.
And there is another method called (proton therapy)
In this method, high-energy positively charged rays will be used to treat and control vestibular schwannoma.