Acoustic neuromas, also known as vestibular schwannomas, are slow-growing, benign tumors of the vestibular nerve that arise from the Schwann cells. They account for 80% of cerebellopontine angle tumors and 10% of all brain tumors. Symptoms vary depending on location but may include hearing loss, tinnitus, vertigo, facial pain, and headache. Diagnosis involves tests like MRI, CT scans, audiograms and neurological exams. The primary treatment is surgical removal via approaches like the middle cranial fossa or retrosigmoid methods, while radiation can help smaller tumors. Risks of surgery include facial nerve paralysis, CSF leakage and meningitis.

1. Acoustic neuroma
Mr. Binu Babu
M.Sc. Nursing
Mrs. Jincy Ealias
M.Sc. Nursing

2. 
 Inner ear tumors can be benign or malignant.
 Acoustic neuromas are benign tumors of cranial
nerve VIII.
 Malignant tumors arising from the inner ear are rare.
 Squamous and basal carcinomas arise from the
epidermal lining of the inner ear.

3. 
 Acoustic neuromas are slow-growing, benign tumors
of cranial nerve VIII, usually arising from the
Schwann cells of the vestibular portion of the nerve.
 Usually occurs unilaterally
 Also called VESTIBULAR SCHWANNOMA
Acoustic neuroma

4. 

5. 
 80% of Cerebellopontine angle tumours
 10% of all brain tumours
Incidence

6. 
 Idiopathic
 Gene malfunctioning: Malfunctioning of gene on
chromosome no. 22. Normally these gene produces a
tumor suppressor protein that control the growth of
Schwann cells covering nerves.
Etiology

7. 
 Age: middle age
 Sex: M=F
 Genetic disorder: Neurofibromatosis type 2.
Risk factors

8. Tumors arise from schwann cell
Slow growth of tumor
Compresses vestibular fibers
Destruction of vestibular fibers produce mild balance problems
Tumor grow further
Large enough to fill the internal auditory canal
Growth extending into the cerebellopontine angle
Compress brain stem, cochlear nerve, vestibular nerve, or labyrinthine artery
Hearing loss or vestibular disturbance
Pathophysiology

9. 
 Unilateral tinnitus
 Hearing loss
 Vertigo or balance disturbance may or may not
present
 Headache
 Facial pain
 The symptoms vary depending on the area of the ear
involved.
Clinical features

10. 
 History collection
 Physical examination
 Neurological examination
 Hearing test
 Audiogram
 CT and MRI are used to determine size and location of
the tumor
 Lumbar puncture : Analysis of CSF fluid shows increased
protein
 Auditory brainstem evoked response (ABR)
 Electronystagmography (ENG)
Diagnostic measures

11. 
 Radiation therapy to decrease the size of the tumor
 Chemotherapy or for inoperable tumors.
 Surgical removal of acoustic tumors is the treatment
of choice
Management

12. 
 Surgical approach depends upon size and extent of
tumor.
 Approaches:
 Middle cranial fossa approach
 Translabyrinthine approach
 Suboccipital(retrosigmoid) approach
 Combined translabyrinthine-suboccipital approach

13. 
 facial nerve paralysis
 cerebrospinal fluid leakage
 Meningitis
 cerebral edema
Complications of surgery