Vestibular Schwannoma

Note: Historically, these tumours were called Acoustic Neuromas, yet this terminology is no longer used.

Overview


Tumour Group: Non-Malignant Brain Tumour
WHO Grade: Grade I
Prevalence/Incidence: Vestibular schwannomas represent 8% of intracranial tumours. Annual incidence is approx. 1/100,000.
Typical Age Range: All ages are affected but pediatric cases are rare.

Contents
Description of Tumour
Symptoms
Treatment / Standard of Care
Prognosis
References

Description of Tumour


A vestibular schwannoma is also known as an acoustic neuroma, schwannoma, or neurilemmoma. A vestibular schwannoma affects the nerves responsible for hearing and balance.

This type of non-malignant brain tumour grows from the sheath surrounding the eighth cranial nerve and as a result can cause such symptoms as hearing loss, balance difficulty and tinnitus. The size of the tumour when first diagnosed is variable and in some cases can be quite large.

Symptoms


Common symptoms include, but are not necessarily limited to:

  • Dizziness or vertigo
  • Hearing loss in one ear
  • Lack of coordination
  • Tingling or numbness in the face
  • Tinnitus (ringing in the ear)
  • Walking and balance problems
  • Double vision
  • Trouble with speech or swallowing

Because many of the symptoms are also indicative of other, less serious ailments, vestibular schwannomas are often misdiagnosed or remain undetected.

Treatment / Standard of Care


There are three treatment options available:

  • Observation (monitoring)
  • Microsurgical removal (partial or total)
  • Stereotactic radiosurgery (single fraction) or radiotherapy (multiple daily fractions delivered using stereotactic techniques)

Some of the factors that influence the optimal treatment strategy include the age of the patient, the size of the tumour, whether the tumour is growing, whether symptoms are present (e.g. imbalance or tinnitus), the quality of the hearing before treatment, the individual results of the surgeon, and the patient’s personal preferences. It is important the patient is fully counselled with regards to the risks and benefits of each option.

Vestibular schwannomas can be difficult tumours to remove surgically. Patients with vestibular schwannomas should be referred to neurosurgeons with particular expertise in surgery for this tumour type.

Prognosis  


A prognosis is an estimate of the likely progress of a disease after a diagnosis, based on an average patient group. Since every person is different, please take time to talk with your health care team about how this information applies to you.

By clicking on 'Expand,' a statistic on the prognosis for vestibular schwannomas will be shown.

Expand for Prognosis Information

For brain tumour patients, a prognosis depends on several factors, which can include age and other health issues, the size of the tumour, its molecular profile, the type of tumour, how much can be removed and its response to treatments such as chemotherapy and radiation therapy.

The outcomes relevant to vestibular schwannoma management include facial function, hearing (if present prior to treatment), extent of resection of the tumour if operated, or lack of growth for irradiated tumours, quality of life, and other symptoms such as headaches, dizziness, and facial numbness.

Grade I brain tumours tend to have the most favourable survival rates compared to higher grade brain tumours. Although non-malignant, if untreated, vestibular schwannoma can in rare situations be life-threatening, particularly if the tumour is very large. This makes it imperative that individuals with persistent inner-ear problems be evaluated to eliminate the possibility of vestibular schwannoma.
 

References


"About Acoustic Neuroma." ANAC. N.p., n.d. Web. 8 July 2013.

"Acoustic Neuroma: Overview." Acoustic Neuroma: Overview. N.p., n.d. Web. 09 Aug. 2013.

Adult Brain Tumour Handbook 6th Edition. Brain Tumour Foundation of Canada. 2012.

Non-Malignant Brain Tumour Handbook. Brain Tumour Foundation of Canada. 2011.

Pediatric Brain Tumour Handbook 6th Edition. Brain Tumour Foundation of Canada. 2012.

Louis, David N. WHO Classification of Tumours of the Central Nervous System. Lyon: International Agency for Research on Cancer, 2007. Print

"Patient.co.uk - Trusted Medical Information and Support." Patient.co.uk. N.p., n.d. Web. 09 Aug. 2013.

"What Is an Acoustic Neuroma?" What Is an Acoustic Neuroma? N.p., n.d. Web. 09 August. 2013.

Image credited to http://radiopaedia.org/articles/acoustic_schwannoma

 

For more information, please see our Information Sheet on vestibular schwannomas.

 

 You can also download this information as a Information Sheet on Vestibular Schwannomas (pdf). 

Scott is a vestibular schwannoma survivor. It was his wife, Jackie, who first noticed symptoms, such as hearing loss and balance problems, while Scott was training for a 2008 marathon and triathlon. “My hope would be that anyone diagnosed with a brain tumour would be able to do the treatment, have a successful outcome, and no more worries,” says Scott.

Read Scott's story of hope >>

 

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