ENT - Acoustic Neuroma

Question 1

What are acoustic neuromas?

Answer 1

Benign tumours of the Schwann cells surrounding the vestibulocochlear nerve

Question 2

Where do acoustic neuromas typically occur?

Answer 2

At the cerebellopontine angle

Can be called cerebellopontine angle tumour

Question 3

Are acoustic neuromas usually unilateral or bilateral?

Answer 3

Unilateral

Bilateral acoustic neuromas are associated with neurofibromatosis type II

Question 4

What is the typical age range for patients with acoustic neuromas?

Answer 4

40-60 years

Gradual onset of
- Unilateral sensorineural hearing loss
- Unilateral tinnitus
- Dizziness or imbalance
- Fullness sensation in ear

Can be assocaited with facial nerve palsy if tumour grows large enough to compress the facial nerve

Question 5

What investigation is used to assess hearing loss in acoustic neuromas?

Answer 5

Audiometry

Sensorineural pattern

Question 6

What is used to establish diagnosis of an acoustic neuroma?

Answer 6

MRI or CT

MRI proves more detail

Question 7

How are acoustic neuromas managed?

Answer 7

Conservative
Management with monitoring can be used if there are no symptoms or treatment is inappropriate

Surgery
Remove the tumour (partial or total)

Radiotherapy
Reduce the growth

Question 8

What are notable risks associated with the treatment of acoustic neuromas?

Answer 8

• Vestibulocochlear nerve injury, with permanent hearing loss or dizziness
• Facial nerve injury, with facial weakness