Acoustic Neuroma: When a Growth Affects Your Balance and Hearing

Acoustic Neuromas are benign tumors on the hearing and balance nerve. Early signs include one-sided hearing loss and tinnitus. Our specialists provide precise diagnosis and personalized "watchful waiting" or surgical care. Would you like me to generate a clinical image showing the tumor’s location relative to the inner ear and brainstem?

  • 02 Feb, 2026
  • Dr. Rama Krishnaiah V

In the field of ENT, we often deal with conditions that affect how you hear and how you stay on your feet. One of the most significant, though rare, conditions we manage is an Acoustic Neuroma (also known as a Vestibular Schwannoma).While the word "neuroma" sounds intimidating, it is important to start with the facts: an acoustic neuroma is a benign (non-cancerous), usually slow-growing tumor. However, because of its location on the main nerve leading from your inner ear to your brain, it can have a profound impact on ENT health.

What Exactly Is an Acoustic Neuroma?

This tumor develops on the vestibular nerve (the eighth cranial nerve). This nerve is responsible for two vital functions:
  1. Hearing (the cochlear branch)
  2. Balance (the vestibular branch)
As the tumor grows, it presses against these nerve fibers and can eventually push against the brainstem or the facial nerve.

How It Affects ENT Health

Because the tumor sits in such a "high-rent" district of the head, the symptoms are primarily sensory:

1. Progressive Hearing Loss

The most common sign is a gradual loss of hearing in one ear only. Patients often notice they have trouble hearing on the phone or localizing where sounds are coming from.

2. Tinnitus (Ringing in the Ear)

A persistent ringing, buzzing, or hissing in the affected ear is a frequent early warning sign. While tinnitus has many causes, unilateral (one-sided) tinnitus always warrants an ENT evaluation.

3. Balance Issues and Vertigo

Since the tumor originates on the balance nerve, many patients experience:
  • Unsteadiness or a feeling of being "off-balance."
  • True vertigo (the sensation that the room is spinning), though this is less common than general instability.

4. Facial Numbness or Weakness

In larger tumors, the growth may press on the facial nerve (cranial nerve VII), which sits right next to the hearing nerve. This can lead to tingling, numbness, or even weakness in the facial muscles on one side.

Diagnosis and "The Gold Standard"

At our practice, we don't guess—we test. If you present with one-sided hearing loss or tinnitus, our diagnostic process usually includes:
  • Audiometry: A formal hearing test to determine the pattern of nerve loss.
  • MRI with Contrast: This is the "gold standard" for diagnosis, as it can catch even very small tumors that a standard CT scan might miss.

Management Strategies: The Three Paths

Not every acoustic neuroma requires immediate surgery. Depending on the size of the tumor and your age, we may recommend:
  1. Observation ("Watch and Wait"): For small tumors with minimal symptoms, we monitor with yearly MRIs.
  2. Stereotactic Radiosurgery: Using precise radiation (like Gamma Knife) to stop the tumor from growing further.
  3. Microsurgical Removal: If the tumor is large or growing rapidly, an ENT surgeon (specifically a Neurotologist) will surgically remove it.