Learn about vestibular schwannoma and how it is treated.
What it is
Vestibular schwannomas start in the Schwann cells (fatty cells) on the outside of the 8th cranial nerve. This nerve runs from the brain to the ear and controls hearing and balance. They are also called acoustic neuromas.
They are nearly always slow growing, do not spread, and are thought of as benign tumours. Often they have been there a long time by the time they are diagnosed.
Vestibular schwannomas are found most often in older people. Loss of hearing in one ear can be a sign of vestibular schwannoma.
Rarely, they are associated with a genetic condition called neurofibromatosis. People with neurofibromatosis are usually diagnosed at a much younger age and tumours might be on both sides of the brain (bilateral). Those affected might also develop another type of brain tumour called meningiomas.
Treatment will depend on the size of your tumour.
Diagnosing vestibular schwannoma
Your doctor will examine you and you might have blood tests to check your general health. Other tests include:
- MRI scan
- hearing tests
For a very small tumour you might not need treatment straight away. Your specialist might recommend monitoring your tumour with regular MRI scans. This is called watchful waiting.
Small tumours may be treated with stereotactic radiotherapy. A possible side effect is nerve damage, which can develop several months or years later.
You might also have radiotherapy after surgery if your tumour has not completely been removed.
Usually a brain surgeon (neurosurgeon) and an Ear, Nose and Throat (ENT) surgeon work together. There are different types of surgery to remove the tumour, they will discuss the options with you.
Surgeons might remove the tumour through a hole in your skull. This type of surgery tries not to damage your hearing. It might cause drooping of your face (facial palsy), or problems with speaking and swallowing. You might have dryness and soreness in your eye on the side of surgery.
A different type of surgery removes the tumour through your ear. This operation is more likely to damage your hearing. But it might reduce the risk of numbness or loss of movement in your face. Some people are partly or completely deaf after this type of operation.
Unfortunately, you will almost certainly be deaf after surgery to remove tumours on both sides of your brain. Your surgeon might delay your operation for as long as possible so that you keep your hearing as long as you can.
Coping with vestibular schwannoma
Coping with a diagnosis of a brain tumour can be difficult, both practically and emotionally. It can be especially difficult if you have a rare type of tumour. Being well informed about your tumour and its treatment can make it easier to make decisions and cope with what happens.
You will have regular check ups once you finish your treatment. Your doctor will examine you and ask about your general health.
This is your chance to ask questions and to tell your doctor if anything is worrying you.
How often you have check ups depends on your individual situation.
Research and clinical trials
There may be fewer clinical trials for rare types of cancer than for more common types.
It is hard to organise and run trials for rare cancers. Getting enough patients is critical to the success of a trial. The results won't be strong enough to prove that one type of treatment is better than another if the trial is too small.
The International Rare Cancers Initiative (IRCI) aims to develop more research into new treatments for rare cancers. They are designing trials that involve several countries so that more people will be available to enter trials.