ENT - acoustic neuroma Flashcards
What is an acoustic neuroma?
Benign tumour of the Scwann cells surrounding the vestibulocochlear nerve that innervates the inner ear
Aka vestibular schwanomas
Where do they occur?
At the cerebellopontine angle
Unilateral vs bilateral
Acoustic neuromas - are usually unilateral
Bilateral acoustic neuromas - almost certainly means NF type 2
Typical presentation of acoustic neuroma
Usually 40-60 years old with gradual onset of:
- Unilateral sensorineural hearing loss (often the 1st Sx)
- Unilateral tinnitus
- Dizziness or imbalance
- A sensation of fullness within the ear
Can also be associated with a facial nerve palsy if the tumour grows large enough to compress the facial nerve
Investigations in suspected acoustic neuroma
Audiometry - will show sensorineural pattern of hearing loss
Rinne’s and Weber’s test
MRI or CT brain (MRI provides more detail than CT)
Management of acoustic neuroma
Conservative management with monitoring may be used if there are no symptoms or treatment is inappropriate
Surgery to remove the tumour (partial or total removal)
Radiotherapy to reduce the growth
Risks associated with treatment
Vestibulocochlear nerve injury - with permanent hearing loss or dizziness
Facial nerve palsy - facial weakness