Summary about Disease
Vestibular schwannoma, also known as acoustic neuroma, is a benign (non-cancerous) tumor that develops on the vestibulocochlear nerve (8th cranial nerve). This nerve leads from the inner ear to the brain and is responsible for hearing and balance. As the tumor grows, it can press on the nerve, causing hearing loss, tinnitus (ringing in the ear), dizziness, and balance problems. It can also affect nearby structures as it enlarges.
Symptoms
Gradual hearing loss (usually in one ear)
Tinnitus (ringing in the ear)
Dizziness or vertigo
Balance problems
Facial numbness or tingling (rare)
Headaches
Changes in taste
Causes
Most vestibular schwannomas occur sporadically (without a known cause). However, some cases are associated with a genetic condition called Neurofibromatosis type 2 (NF2). In NF2, individuals develop multiple tumors, including vestibular schwannomas, often in both ears. The exact cause of sporadic vestibular schwannomas remains unknown, but they arise from an overproduction of Schwann cells.
Medicine Used
There is no medicine to shrink or eliminate a Vestibular Schwannoma. Medicines are used to treat the symptoms (vertigo, dizziness). Some examples are:
Antiemetics: Prochlorperazine or metoclopramide may relieve nausea and vomiting related to vertigo.
Antihistamines: Meclizine or dimenhydrinate can help reduce vertigo.
Benzodiazepines: Diazepam or lorazepam can be used short-term to manage severe vertigo.
Is Communicable
No, vestibular schwannoma is not communicable. It is not an infectious disease and cannot be spread from person to person.
Precautions
There are no specific precautions to prevent vestibular schwannoma, especially in sporadic cases where the cause is unknown. For individuals with NF2, genetic counseling and regular monitoring are important.
How long does an outbreak last?
Vestibular schwannoma is not an "outbreak" as it is a tumor that grows slowly over time. Symptoms can develop gradually and persist unless the tumor is treated.
How is it diagnosed?
Audiogram (Hearing Test): To assess hearing loss.
MRI with contrast: The primary imaging tool to detect and visualize the tumor. Gadolinium contrast is used to enhance the tumor's visibility.
Auditory Brainstem Response (ABR): A test that measures the brain's response to sound, which can help identify problems with the auditory nerve.
Electronystagmography (ENG): A test to evaluate balance function.
Timeline of Symptoms
The timeline of symptoms varies greatly depending on the tumor's growth rate and location. Generally:
Early Stages: Gradual hearing loss and tinnitus may be the initial symptoms, often subtle and easily dismissed.
Progressive Growth: As the tumor enlarges, dizziness, balance problems, and facial numbness or weakness may develop.
Late Stages: Large tumors can press on the brainstem, leading to more severe symptoms like headaches, vision problems, and hydrocephalus (fluid buildup in the brain).
Important Considerations
Treatment Options: Treatment options include observation (monitoring the tumor's growth), stereotactic radiosurgery (such as Gamma Knife), and microsurgical removal. The choice of treatment depends on the tumor size, location, patient's age, overall health, and hearing level.
Hearing Preservation: Preserving hearing is a major consideration in treatment planning.
Facial Nerve Function: Protecting the facial nerve (which controls facial movements) is another key concern during surgery.
Long-Term Follow-up: Regular follow-up appointments and imaging studies are crucial to monitor for tumor regrowth or complications after treatment.
Multidisciplinary Approach: Management of vestibular schwannoma often involves a team of specialists, including neurosurgeons, otolaryngologists (ENT surgeons), audiologists, and radiation oncologists.