Acoustic neuroma

The acoustic neuroma is also known as vestibular schwannoma and is a benign primary intracranial tumour. More than 95 % of all acoustic neuromas only occur on one sight. In connection with neurofibromatosis type II they typically appear on both sides.
   

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Histology of Acoustic Neuroma

  • slowly growing, benign tumours (WHO I)
  • arise from Schwann cells

 

Epidemiology of Acoustic Neuroma
 

  • occur in in middle age
  • frequency: 1/100 000
  • less than 5 % of acoustic neuroma are on both sides

 

Symptoms of Acoustic Neuroma
 

  • hearing loss (mostly on one side)
  • noise in the ear
  • dizziness
  • equilibrium disturbance
  • disturbance of sensitivity in the face
  • paralysis of the facial nerve (facial paralysis)
  • uncertain gait

 

Diagnosing Acoustic Neuroma
 

  • ENT-diagnostic: hearing and balance tests, electrophysiological examination
  • MRI and CT
  • Contrast enhancing and clear demarcation of the tumour
  • in MRI: hypo-isointense in T1, hyperintense in T2
  • in CT: bony extension of the inner ear canal
  • main localisation in cerebellopontine angle or inner ear canal

 

Therapy of Acoustic Neuroma
 

  • „wait and scan“
  • if possible, complete surgical removal
  • alternatively radiosurgery and stereotectic radiotherapy

 

Therapy of Recurrent Acoustic Neuroma
 

  • re-operation
  • irradiation, possibly radiosurgery

 

Aftercare of Acoustic Neuroma
 

  • after therapy: MRI´s up to five years

 

Course of Acoustic Neuroma
 

  • very slowly growing, approximately 1 to 5 mm per year
  • also stangnant cases are known

 

Prognosis of Acoustic Neuroma
 

  • after complete surgical removal normal life expectancy can be reached
  • only in very rare cases malignant forms have been seen

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