Acoustic Neuroma (Vestibular Schwannoma): Symptoms, Diagnosis, Treatment and Support
An acoustic neuroma, also known as a vestibular schwannoma, is a benign, usually slow-growing tumour that develops on the hearing and balance nerve connecting the inner ear to the brain. Although it is not cancer, it can still cause significant problems, particularly if it affects hearing, balance, nearby nerves or, in rare cases, the brainstem.
For many people, the first signs are subtle. Symptoms often develop gradually and may be mistaken for more common ear or hearing issues. That is one reason acoustic neuroma can be difficult to detect early.
What is an acoustic neuroma?
An acoustic neuroma is a tumour that grows from Schwann cells, which are the cells that surround and support nerves. In this case, the tumour usually develops on the vestibular branch of the vestibulocochlear nerve, which is why the medical term is vestibular schwannoma. This nerve carries hearing and balance information from the inner ear to the brain.
These tumours are usually non-cancerous and often grow slowly, but they can still affect quality of life and may require monitoring or treatment depending on their size, growth and symptoms.
Acoustic neuroma, also called vestibular schwannoma, can affect hearing, balance and communication. Image: Blausen.com staff (2014). “Medical Gallery of Blausen Medical 2014“. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.
Acoustic neuroma symptoms
Symptoms vary from person to person, but the most common early signs are:
- hearing loss in one ear, or hearing loss that is noticeably worse on one side
- tinnitus, often in the affected ear
- imbalance or unsteadiness
- dizziness or vertigo
Some people may also experience:
- a feeling of fullness in the ear
- facial numbness or tingling
- facial muscle twitching or, less commonly, weakness
- headaches or pressure symptoms if the tumour becomes larger
- trouble with nearby nerves in more advanced cases
A key point is that one-sided or asymmetric hearing symptoms can be more concerning than general hearing difficulty, because they may point to something more specific that needs medical assessment.
When should you seek medical advice?
You should speak with a doctor or hearing health professional if you notice:
- hearing loss in one ear
- tinnitus mainly in one ear
- ongoing dizziness or balance problems
- unexplained facial numbness
- a combination of these symptoms
These symptoms do not automatically mean you have an acoustic neuroma, but they do deserve proper assessment, especially when they are one-sided or persistent.
How is an acoustic neuroma diagnosed?
Diagnosis usually starts with a review of symptoms and a clinical assessment. Because symptoms can overlap with other ear conditions, further testing is often needed.
Common tests may include:
- hearing tests (audiometry) to check the type and degree of hearing loss
- balance or vestibular testing in some cases
- MRI, which is the main scan used to confirm an acoustic neuroma and can detect even small tumours
If an acoustic neuroma is confirmed, people are often referred to a specialist team with experience managing these tumours.
Acoustic neuroma treatment options
Treatment depends on a range of factors, including the size and location of the tumour, whether it is growing, your hearing levels, your age and general health, and your own preferences.
Options may include:
Observation
Some small tumours grow very slowly or not at all. In these cases, the specialist team may recommend watching and monitoring the tumour with repeat scans and follow-up appointments.
Surgery
Surgery may be recommended if the tumour is larger, growing, or causing more significant symptoms. The aim may be to remove the tumour while preserving nerve function as much as possible.
Radiation therapy or stereotactic radiosurgery
Some people are treated with stereotactic radiosurgery, such as Gamma Knife, which delivers targeted radiation to stop or slow tumour growth without open surgery.
Hearing and balance rehabilitation
Even when the tumour itself has been treated, some people still need support for hearing loss, tinnitus, balance problems or communication difficulties. That can include hearing aids, cochlear implants in selected cases, vestibular rehabilitation, communication strategies, and broader support services.
Recovery after acoustic neuroma treatment
Recovery is highly individual. Some people recover well with relatively few ongoing effects, while others continue to manage hearing loss, tinnitus, dizziness, facial nerve issues or fatigue after treatment. Even when treatment is successful, these longer-term impacts can affect communication, work, driving and daily life.
Because of this, follow-up care can be just as important as treatment itself. Ongoing support may involve specialists, audiologists, physical therapy, hearing rehabilitation or communication support, depending on the person’s needs.
What is the outlook?
The outlook for acoustic neuroma is often good, particularly when it is detected early and managed appropriately. These tumours are usually benign, and many are slow growing. However, larger tumours can become serious if they press on nearby structures, so monitoring and specialist advice matter.
For some people, the main long-term issue is not the tumour itself but the lasting effect on hearing, balance, tinnitus, confidence and communication.
Support for people living with acoustic neuroma
If you have been diagnosed with an acoustic neuroma, are recovering from treatment, or are living with ongoing hearing and communication difficulties, support is available.
Better Hearing Australia Brisbane supports people who are hard of hearing and can help connect you with practical information, hearing-related support and community connection. If hearing loss, tinnitus, listening fatigue or communication challenges are part of your acoustic neuroma journey, you do not have to navigate that alone. BHA may also be able to connect you with peer support and other services that understand the impact of hearing loss on everyday life.
Contact BHA Brisbane to learn more about available support.
More information
For further information about acoustic neuroma / vestibular schwannoma, speak with your doctor or specialist and refer to trusted health sources such as:
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