Hearing loss is the hallmark symptom of a vestibular schwannoma, a rare type of brain tumor. If a patient notices new changes in hearing, prompt medical treatment may be necessary to prevent further loss. Centers for Neurosurgery, Spine & Orthopedics (CNSO) treats brain tumors, including vestibular schwannomas, for patients across New Jersey. Here, CNSO experts discuss the relationship between hearing loss and vestibular schwannoma.
Quick Facts About Vestibular Schwannoma
- Vestibular schwannoma is a type of tumor that forms on the vestibular nerve and travels with the cochlear nerve (hearing) into the inner ear.
- The tumor presses against and can damage the cochlear nerve, impacting its ability to relay information about hearing. Vestibular schwannoma can also press against surrounding brain structures, called the cerebellum and brainstem, causing serious neurological symptoms.
- Treatment options for vestibular schwannoma include watchful waiting (observation), removal through brain surgery, and radiation therapy.
- Treatment may or may not restore hearing, depending on how much sensation was lost.
What Is a Vestibular Schwannoma?
Vestibular schwannomas, originally called acoustic neuromas, are benign, slow-growing tumors that form from Schwann cells on the vestibular nerve. This nerve connects the inner ear to the brain. The Schwann cells wrap around it like skin, providing support and insulation to enhance nerve function. Tumors form when a DNA change in Schwann cells triggers unregulated cell division. The result is a mass of abnormal cells that press against surrounding tissue.
How Tumors Affect Hearing
The vestibular nerve connects the semicircular canals (responsible for balance) located in the inner ear to the brain and supplies vital information about balance and the position of the head. Because vestibular schwannomas form on this nerve, they press directly against the cochlear nerve, causing tinnitus and hearing loss. Patients with vestibular schwannomas often experience the following symptoms, including:
- Difficulty hearing
- Difficulty locating where sounds come from
- Tinnitus, or a ringing, roaring, or buzzing in the ear
- Total hearing loss
These changes typically affect one ear at a time and may develop gradually or suddenly. Spontaneously regaining lost hearing is also possible. If left untreated, however, vestibular schwannomas can damage the cochlear nerve, resulting in permanent hearing loss.
Other Symptoms to Watch For
Hearing changes are not the only signs of a vestibular schwannoma. Especially as the tumor gets larger, it may impact other structures in the brain. This can cause additional symptoms, including:
- Feelings of fullness in the ear
- Dizziness or vertigo
- Balance problems
- Numbness in the face
- Facial twitching
- Dry eye or unexpected tears
- Changes in taste
- Difficulty swallowing
- Pressure headaches
These symptoms are not always caused by a brain tumor. Any neurological changes, however, are potentially serious. Patients experiencing symptoms like those described above should always seek diagnosis and treatment from a specialist to prevent permanent complications.
Treatment Approaches for Vestibular Schwannoma
If a patient has fully lost hearing due to vestibular schwannoma, their hearing may not be recoverable. If not, however, then treating the schwannoma may preserve and sometimes improve their remaining sense of hearing. How much hearing is restored depends on the treatments used, which can include:
- Watchful waiting: Best for small tumors, this approach simply monitors the tumor. It is most often recommended for patients who still have good hearing. However, recent studies show that almost all vestibular schwannomas are growing, and a watchful waiting approach is best for older patients with small tumors and without symptoms.
- Radiation therapy: This therapy most commonly uses stereotactic radiosurgery (gamma knife or CyberKnife) to deliver very focused beams of radiation to non-invasively treat the tumor and prevent it from growing. This treatment does not remove or cause the tumor to disappear, but it controls the growth of the mass and prevents it from getting bigger. It cannot restore hearing, but it can prevent further loss.
- Brain tumor surgery: This approach seeks to fully remove the tumor. It can sometimes improve hearing, especially if the patient retains some hearing ability. Open surgery is typically reserved for moderate to large tumors that are causing pressure on the brain and cranial nerves. However, recent studies have shown that surgery is effective and safe to treat smaller tumors with as good or better odds of preserving hearing as compared to stereotactic radiosurgery.
The brain tumor specialist will help the patient understand what treatments are available to them and what outcomes are possible with their chosen approach.
Find Vestibular Schwannoma Treatment Near You in New Jersey
Hearing loss from vestibular schwannoma has a significant impact on a person’s quality of life. Fortunately, this consequence can be avoided with prompt treatment at Centers for Neurosurgery, Spine & Orthopedics. As New Jersey’s most comprehensive brain and spine center, CNSO offers cutting-edge care at convenient locations near you across New Jersey. To learn more about vestibular schwannoma treatment, contact CNSO today.
FAQ About Vestibular Schwannomas
What are the early warning signs of vestibular schwannoma?
The first symptoms of vestibular schwannoma are often tinnitus, partial hearing loss, difficulties with balance, and vertigo.
What causes vestibular schwannoma?
Vestibular schwannoma occurs when Schwann cells start multiplying rapidly. Doctors are not always sure what causes this change. It is sometimes linked to neurofibromatosis type 2, a genetic disorder that creates mutations in Schwann cells and a higher likelihood of tumors.
Who is most at risk of vestibular schwannoma?
Anybody can develop a vestibular schwannoma. However, it is most common in individuals between the ages of 50 and 60. Other risk factors include chronic exposure to loud noises and ionizing radiation.
Can hearing loss be saved with treatment?
If the cochlear nerve has already been destroyed, then treatment will not restore a patient’s hearing. Patients who still retain some of their hearing, however, can preserve it and sometimes improve it with treatment.
What vestibular schwannoma treatment options preserve hearing?
Some surgical approaches can preserve or restore hearing that was lost due to a vestibular schwannoma. Radiation therapy can also preserve the patient’s remaining hearing, but it cannot improve it.
How is the cause of hearing loss diagnosed?
Sudden hearing loss is diagnosed with a combination of tests to rule out possible causes. These include:
- Physical examination
- Hearing test
- Neurological exam
- Magnetic resonance imaging (MRI) scan
