Saarland University Medical Center and Saarland University Faculty of Medicine
Vestibular schwannoma (acoustic neuromas)

Vestibular schwannoma (acoustic neuromas)

These benign tumors arise from the sheath of Schwann cells of the 8th cranial nerve (vestibulocochlear nerve), the responsible part for equilibrium. Since this nerve is responsible for the transmission of impulses of the ear, hearing impairment of the affected side is often a first symptom and should not be confused with a sudden hearing loss. With further growth - as described above - balance and gait disturbances can occur.

 

There are three potential treatments:


1) The surgical removal of the tumor, which in a high percentage of cases leads to healing
2) The selective irradiation of the tumor (radiosurgery)
3) Watchful observation in case of known slow tumor growth, especially on elderly or patients at risk

 

The decision on the treatment method may ultimately fall only after intense discussion with the patient. The surgical treatment should be prioritized according to the current state of knowledge, especially among young otherwise healthy patients with observed tumor growth or neurological deficits such as hearing impairment, balance disorder, gait disturbance, etc. In the case of small tumors there is a particular chance to remove the tumor by saving the hearing of the affected ear. Overall, the risk of permanent hearing loss is about 5%.

 

MRI images T1-weighted after contrast agent was injected (left: axial; right: coronal) of a patient with an acoustic neuroma.