Vestibular schwannoma

  • Acoustic neuroma = vestibular schwannoma
    • In internal acoustic canal or cerebellopontine angle
    • Benign tumor of Schwann cells
    • Older adults
    • Unilateral – spontaneous
    • Bilateral – NF2
    • Clinical features
      • Early symptoms
        • Unilateral SNHL
        • Tinnitus
        • Dizziness
        • Unsteady gait
      • Late symptoms – compression of cerebellopontine angle
        • Trigeminal nerve – paraesthesia or facial pain
        • Facial nerve – facial palsy
        • Cerebellum – ataxia
        • 4th ventricle – hydrocephalus
    • Diagnosis
      • Pure tone audiometry – SNHL of higher frequencies
      • Brainstem-evoked audiometry
      • Contrast MRI
    • Treatment
      • Surgery or radiation – if large or significant symptoms
      • Observation‎