Acoustic Neuroma treatment ppt

What is an acoustic neuroma?

An acoustic neuroma is a rare type of brain tumour (growth). It is a benign (noncancerous) tumour.

The tumour grows along a nerve in the brain (a cranial nerve) that is called the acoustic or vestibulocochlear nerve. This nerve controls your sense of hearing and balance.

Acoustic neuromas grow from a type of cell called a Schwann cell. These cells cover and insulate nerve cells. This is why the tumour is also called a vestibular schwannoma.

Acoustic neuromas tend to grow very slowly and they don't spread to distant parts of the body. Sometimes they are too small to cause any problems or symptoms. Bigger acoustic neuromas can interfere with the function of the vestibulocochlear nerve.

What is the cause of acoustic neuromas?

The cause of most acoustic neuromas is unknown.

About 7 out of every 100 acoustic neuromas are caused by neurofibromatosis type 2 (NF2). NF2 is a very rare genetic disorder that causes benign tumours of the nervous system. It affects about 1 in 350,000 people. Almost everyone with NF2 develops an acoustic neuroma on both acoustic nerves (ie, bilateral tumours). People with NF2 can also get benign tumours on the spinal cord and the coverings of the brain.

How common are acoustic neuromas?

Acoustic neuromas are rare. About 13 people in every million are diagnosed each year with an acoustic neuroma in the UK.

Brain tumours themselves are rare. Brain tumours can be benign (noncancerous) or malignant (cancerous). Brain tumours are divided into two main groups:

• Primary brain tumours originate in the brain. An acoustic neuroma is a primary brain tumour.
• Secondary brain tumours are tumours in the brain that have spread from other parts of the body. They are often referred to a secondaries or brain metastases. These are malignant tumours.

Acoustic neuromas account for about 8 in 100 primary brain tumours. They are more common in middle-aged adults, generally between the ages of 30 and 60 years and extremely rare in children.

Acoustic neuromas seem to be more common in women than men.

What are the symptoms of an acoustic neuroma?

A small acoustic neuroma may cause no symptoms. If you do get symptoms from an acoustic neuroma, these may develop very gradually, as the tumour is so slow-growing.

The symptoms that an acoustic neuroma can cause are very common in the general population. Remember that acoustic neuromas are very rare. You should see your doctor if you have any of these symptoms, but they are more likely to be due to other conditions than a brain tumour.

The most common symptoms of an acoustic neuroma are:

• Hearing loss. Some degree of deafness occurs in 9 in 10 people with an acoustic neuroma. Usually hearing loss is gradual and affects one ear. (Remember old age and earwax are much more common causes of deafness.) The type of deafness caused is called sensorineural deafness and means the nerve for hearing (the acoustic nerve) is damaged. Hearing tests with a tuning fork can help to determine if the deafness is due to a nerve problem, or whether it is more likely due to a blockage in the ear (also known as conductive deafness).
• Tinnitus. This is the medical name for ringing in the ears. About 7 in 10 people with an acoustic neuroma have tinnitus in one ear. The sounds can vary; it does not have to be ringing like a bell. Tinnitus describes any sounds heard within the ear when there is no external sound being made. Tinnitus is a common symptom and not a disease in itself. Other causes of tinnitus include earwax, ear infections, ageing and noise-induced hearing loss.

Other, common symptoms of acoustic neuroma include:

• Vertigo. This is the sensation of the room spinning, often described as dizziness. It is not a fear of heights as some people incorrectly think. This feeling of movement occurs even when you are standing still. Vertigo can be caused by other conditions affecting the inner ear. Nearly half of people with an acoustic neuroma have this symptom, but less than 1 in 10 have it as their first symptom.
• Facial numbness, tingling or pain. These symptoms are due to pressure from the acoustic neuroma on other nerves. The commonly affected nerve is called the trigeminal nerve which controls feeling in the face. About 1 in 4 people with acoustic neuroma has some facial numbness - this is a more common symptom than weakness of the facial muscles. However, it is often an unnoticed symptom. Similar symptoms can occur with other problems, such as trigeminal neuralgia or a tumour growing on the facial nerve (a facial neuroma).

Less common symptoms of acoustic neuroma are:

• Headache. This is a relatively rare symptom of an acoustic neuroma. It can occur if the tumour is big enough to block the flow of cerebrospinal fluid (CSF) in the brain. CSF is the clear, nourishing fluid that flows around the brain and spinal cord, protecting the delicate structures from physical and chemical harm. Obstruction to the flow and drainage of CSF can cause a problem called hydrocephalus (also known as water on the brain). This results in increased pressure and swelling, and the brain effectively becomes squashed within the skull. This can cause headache and, if untreated, brain damage.
• Earache. This is another rare symptom of acoustic neuroma. There are many more common causes of earache.
• Visual problems. Again, this is a rare symptom. If it does happen, it is due to hydrocephalus (see above).
• Tiredness and lack of energy. These are nonspecific symptoms and can be due to many causes. It is possible that a nonmalignant brain tumour could lead to this.

Further support and information

British Acoustic Neuroma Association

Web: www.bana-uk.com
A site designed and developed by people affected by acoustic neuroma. There are public areas to the website and an opportunity to become a member of the association.

Action on Hearing Loss

Web: www.actiononhearingloss.org.uk
Formerly the RNID, they are a charitable organisation working on behalf of the UK's 9 million deaf and hard of hearing people. The website offers support, information and even an online shop for products to assist people with impaired hearing.

The Neurofibromatosis Association

Web: www.nfauk.org
A UK-based organisation offering support and information for people affected by the diseases neurofibromatosis 1 and 2.