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