Vestibular Schwannoma: Symptoms and Treatments

Vestibular schwannoma, also known as acoustic neuroma, is a benign tumour that develops on the vestibulocochlear nerve leading from your inner ear to your brain. This condition is significant due to its potential impact on hearing and balance, and understanding it is essential for timely diagnosis and effective management.

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What is Vestibular Schwannoma?

Vestibular schwannoma is characterized by the growth of Schwann cells, which are the cells responsible for the myelin sheath that insulates nerves. These tumours are typically slow-growing and non-cancerous, but they can cause significant complications by pressing on surrounding nerves and brain structures.

Causes and Risk Factors

The exact cause of vestibular schwannoma remains unclear, but several factors may increase the risk of developing these tumours. Genetic factors play a crucial role, particularly in cases associated with neurofibromatosis type II (NF2), a genetic disorder that leads to the growth of tumours on nerve tissues.

Other potential risk factors include exposure to loud noise, radiation exposure, and a family history of the condition. However, more research is needed to fully understand the environmental influences and lifestyle factors that may contribute to this condition.

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Symptoms of Vestibular Schwannoma

Symptoms of vestibular schwannoma can vary depending on the tumour's size and location. Commonly reported symptoms include:

Diagnosis of Vestibular Schwannoma

Diagnosing vestibular schwannoma involves a combination of clinical evaluation and advanced imaging techniques. An otolaryngologist or neurologist typically conducts the initial assessment, which includes hearing tests (audiometry) and balance assessments.

Vestibular Schwannoma Radiology

Magnetic Resonance Imaging (MRI) is the gold standard for diagnosing vestibular schwannoma. It provides detailed images of soft tissues, allowing for the accurate identification of tumours. MRI with gadolinium contrast enhancement is particularly effective, as it highlights the tumour and distinguishes it from surrounding structures. Computed Tomography (CT) scans can also be used, but they are less effective than MRI.

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Treatment Options for Vestibular Schwannoma

The treatment strategy for vestibular schwannoma depends on various factors, including the size of the tumour, the patient’s age, overall health, and the severity of symptoms.

Observation

In cases where the tumour is small and symptoms are mild or absent, a conservative approach of "watchful waiting" may be recommended. This involves regular monitoring with MRI scans to track tumour growth.

Surgical Intervention

Surgery may be necessary if the tumour is large, growing, or causing significant symptoms. Surgical options include:

Radiotherapy

Stereotactic radiotherapy is an option for patients who are not suitable candidates for surgery. It aims to halt tumour growth and preserve neurological function.

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Prognosis for Patients with Vestibular Schwannoma

The prognosis for patients with vestibular schwannoma varies based on the size of the tumour at diagnosis and the chosen treatment method. Generally, early detection and treatment lead to better outcomes. While the condition is benign, complications can arise if the tumour affects brain structures or vital nerves.

Long-term Management and Follow-up

Long-term follow-up is crucial for managing vestibular schwannoma. Regular MRI scans are essential to monitoring for potential tumour regrowth, and ongoing audiological evaluations can help manage hearing loss.