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Acoustic Neuroma

Reviewed 06/2018
 


BASICS

DESCRIPTION

Acoustic neuromas (vestibular schwannomas) are slow-growing, benign, intracranial, extraaxial tumors originating from the vestibulocochlear nerve. 
  • Originated from Schwann cells of th...

DIAGNOSIS

HISTORY

  • Common

    • Sensorineural hearing loss (unilateral), often progressive

    • Sudden deafness

    • Loss of speech discrimination

    • Tinnitus

    • Disequilibrium is common, but vertigo is less common.

  • Less common

    • Wea...

TREATMENT

GENERAL MEASURES

  • Treatment options include observation, stereotactic radiosurgery, fractionated radiotherapy, and microsurgery.

  • Without intervention, 16–26% of patients require additional trea...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Yearly MRI follow-up for slow-growing tumors is advised.

  • MRI and audiometry

  • In one study, composite quality of life (cQOL) score 0 to 5 years out of surgery was sig...

REFERENCES

1
Elliot A, Hebb AL, Walling S, et al. Hearing preservation in vestibular schwannoma management. Am J Otolaryngol.  2015;36(4):526–534. {L-End} [View Abstract on OvidMedline]
2
Olshan M,...

ADDITIONAL READING

  • Bell JR, Anderson-Kim SJ, Low C, et al. The persistence of tinnitus after acoustic neuroma surgery. Otolarygol Head Neck Surg.  2016;155(2):317–323.

  • Choi JW, Lee JY, Phi JH, et ...

CODES

ICD10

D33.3 Benign neoplasm of cranial nerves 

ICD9

225.1 Benign neoplasm of cranial nerves 

SNOMED

126949007 acoustic neuroma (disorder) 

CLINICAL PEARLS

  • The most common presenting signs and symptoms are unilateral sensorineural hearing loss, poor speech discrimination, and tinnitus.

  • May present as sudden deafness

  • MRI with gadolinium is t...

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