bubble_chart Overview

Acoustic neuroma refers to a tumor originating from the sheath of the auditory nerve and is the most common type of intracranial neuroma, accounting for 7-12% of intracranial tumors and 80-95% of cerebellopontine angle tumors. It is more common in adults and rare in individuals under 20 years of age, with no significant gender difference and similar incidence rates on the left and right sides, occasionally occurring bilaterally. Clinically, it primarily manifests as cerebellopontine angle syndrome and signs of increased intracranial pressure. It is a benign tumor, and early diagnosis and treatment yield good outcomes. For larger tumors accompanied by intracranial hypertension, surgery is the only viable option.

bubble_chart Clinical Manifestations

1. Tinnitus or episodic vertigo, with progressive hearing loss to deafness in one ear.
2. Difficulty swallowing, hoarseness, diminished or absent gag reflex, decreased or absent corneal reflex on the same side, deviation of the mouth, etc.
3. Unsteady gait, horizontal nystagmus, and impaired limb coordination.
4. Headache, vomiting, and papilledema.

bubble_chart Diagnosis

1. Tinnitus as the initial symptom, progressive unilateral hearing loss leading to deafness.
2. Typical cerebellopontine angle syndrome: symptoms and signs of auditory nerve, facial nerve, trigeminal nerve, and posterior cranial nerve dysfunction, cerebellar damage, and brainstem compression.
3. Chronic intracranial hypertension signs: headache, vomiting, optic disc edema.
4. Skull X-ray with internal auditory canal view shows enlargement of the internal auditory canal and destruction of the petrous ridge. Head computed tomography (CT) reveals isodense or hypodense lesions in the cerebellopontine angle region and obstructive hydrocephalus, with partial enhancement of the lesion on contrast scan. Head magnetic resonance imaging (MRI) demonstrates low or isointense signals on T1-weighted images and hyperintense signals on T2-weighted images in the cerebellopontine angle region, with significant enhancement of the lesion on contrast scan.

bubble_chart Treatment Measures

1. Surgical treatment is the main approach.
2. Stereotactic radiosurgery (gamma knife, x-knife): for cases without intracranial hypertension and tumor diameter <3cm者可考慮，腫瘤較大者亦可先部分切除和/或腦室分流術緩解顱高壓後再行γ-刀、x-刀治療。
3. Prevent infection, provide neurotrophic therapy, and manage complications.

Acoustic neuroma is a benign tumor, and early diagnosis and treatment yield good outcomes. Tinnitus is the initial symptom of acoustic neuroma; if the tinnitus resembles the chirping of autumn cicadas, immediate consultation with a specialist is necessary. Diagnosis can be confirmed through head CT or MRI. For tumors >3cm in diameter or cases with intracranial hypertension, surgical removal is the only option. If the tumor diameter is <3cm, gamma knife or x-knife treatment may be considered, though the cost is generally high. To date, no specific food or medication has been found to shrink or eliminate the tumor.

bubble_chart Cure Criteria

1. Cure: Complete tumor resection, resolution of intracranial hypertension symptoms, restoration of work and study ability, with or without deviation of mouth.
2. Improvement: Near-total or substantial tumor resection, relief or stabilization of intracranial hypertension symptoms, with or without deviation of mouth.
3. No cure: Tumor biopsy or partial resection, no improvement in intracranial hypertension symptoms.