Acoustic Neuroma (Vestibular Schwannoma) — Patient Guide

A Tumour That Starts With Hearing Loss

Acoustic neuroma — also called vestibular schwannoma — is a non-cancerous tumour that grows on the nerve connecting the inner ear to the brain. It grows slowly and rarely spreads. But because it sits near critical structures, it can cause hearing loss, balance problems, and in large cases, pressure on the brain.

Most people first notice one-sided hearing loss or ringing in the ear. According to the Mayo Clinic, acoustic neuromas account for about 8% of all primary brain tumours. With the right treatment, most patients do very well.

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What Is Acoustic Neuroma?

Acoustic neuroma grows on the vestibulocochlear nerve (the 8th cranial nerve), which carries sound and balance signals from the inner ear to the brain. The tumour grows from Schwann cells — the cells that form the protective sheath around nerve fibres.

According to NCBI PubMed, acoustic neuromas occur in approximately 1 in 100,000 people per year. They are most commonly diagnosed in adults between 30 and 60 years of age. Most cases occur on one side only. Bilateral acoustic neuromas (on both sides) are associated with a rare genetic condition called neurofibromatosis type 2.

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Symptoms of Acoustic Neuroma

Symptoms develop gradually as the tumour grows. The most common early symptom is one-sided hearing loss. Other symptoms include:

• Hearing loss: Usually in one ear, often noticed first as difficulty understanding speech on the phone.
• Tinnitus: Ringing, buzzing, or hissing in the affected ear.
• Balance problems: Unsteadiness or dizziness, especially when moving quickly.
• Facial numbness or weakness: If the tumour presses on the facial nerve (which runs alongside the vestibulocochlear nerve).
• Headache: In larger tumours that press on the brainstem.
• Difficulty swallowing: In very large tumours affecting the lower cranial nerves.

When to see a doctor: Any unexplained one-sided hearing loss or persistent tinnitus should be evaluated by an ENT specialist or neurologist. Early diagnosis leads to better treatment options.

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Causes and Risk Factors

The exact cause of most acoustic neuromas is unknown. The only confirmed risk factor is:

• Neurofibromatosis type 2 (NF2): A rare genetic condition that causes bilateral acoustic neuromas. It accounts for less than 5% of all cases.
• Previous radiation exposure to the head and neck — a possible risk factor in some studies.

Most acoustic neuromas occur without any identifiable cause or family history. They are not caused by mobile phone use — this association has been studied extensively and not confirmed.

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How Is Acoustic Neuroma Diagnosed?

• MRI scan with gadolinium contrast: The gold standard. It shows the tumour's size, location, and relationship to the brainstem and facial nerve with high accuracy.
• Audiogram (hearing test): Measures the type and degree of hearing loss. Asymmetric sensorineural hearing loss is a key diagnostic clue.
• Auditory brainstem response (ABR): Measures the brain's electrical response to sound. Used when MRI is not immediately available.
• CT scan: Less accurate than MRI for soft tissue but useful for assessing bony changes in the internal auditory canal.

Most patients receive a confirmed diagnosis within 2 to 4 weeks of their first scan.

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Treatment Options

The right treatment depends on the tumour's size, your age, your hearing status, and your overall health.

Treatment	When It Is Used
Active surveillance (watch and wait)	Small tumours (under 1.5 cm) in older patients or those with minimal symptoms. Regular MRI every 6 to 12 months.
Stereotactic radiosurgery (Gamma Knife / CyberKnife)	Small to medium tumours (under 3 cm). Single-session targeted radiation. No incision.
Microsurgery (surgical removal)	Large tumours (over 3 cm), tumours causing brainstem compression, or younger patients who want a treat or manage.

Radiosurgery does not remove the tumour — it stops it from growing. Surgery removes it completely but carries risks to hearing and facial nerve function.

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Surgery — What to Expect

Before Surgery

Your neurosurgeon and ENT surgeon will review your MRI and plan the surgical approach. You will have pre-operative blood tests, audiogram, and an anaesthesia assessment. Stop blood-thinning medications 7 to 10 days before surgery.

During Surgery

Three surgical approaches are used depending on the tumour size and your residual hearing:

• Retrosigmoid (suboccipital) approach: The most common. Access through the back of the skull. Hearing preservation is possible.
• Translabyrinthine approach: Through the mastoid bone behind the ear. Complete hearing loss on that side, but excellent facial nerve preservation.
• Middle fossa approach: For small tumours in the internal auditory canal. Best chance of hearing preservation.

Surgery typically takes 4 to 8 hours under general anaesthesia.

After Surgery

You will spend 1 to 2 days in the ICU. Total hospital stay is typically 4 to 7 days. Balance problems and dizziness are common in the first few weeks as the brain adapts.

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Recovery and Rehabilitation

• Week 1: Rest at home. Dizziness and fatigue are common. Avoid driving.
• Weeks 2 to 4: Vestibular physiotherapy begins to help with balance. Gradual return to light activities.
• Months 2 to 3: Most patients return to desk work. Balance continues to improve.
• Month 6 and beyond: Most patients achieve good balance. Hearing outcome depends on the surgical approach used.

Red flag symptoms — seek immediate care if you notice: fever above 38.5°C, increasing headache, facial weakness, wound redness or discharge, or severe vomiting.

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Cost of Acoustic Neuroma Treatment in Bangalore

Hospital Tier	Estimated Cost (INR)	What's Included
Government / Trust Hospital	₹1,00,000 – ₹2,00,000	Basic microsurgery, shared ward
Mid-range Private Hospital	₹3,00,000 – ₹5,00,000	Semi-private room, intraoperative monitoring
Premium / Corporate Hospital	₹5,00,000 – ₹9,00,000	Private room, advanced facial nerve monitoring, Gamma Knife option

Costs are estimates as of April 2026. Gamma Knife radiosurgery costs ₹1,50,000 to ₹4,50,000 as a separate procedure.

Insurance coverage: Acoustic neuroma surgery is covered under most private health insurance policies, CGHS, ESI, and Ayushman Bharat (PM-JAY) for eligible patients. Confirm coverage with your insurer before admission.

To get a personalised cost estimate from verified hospitals in Bangalore, submit your details on Patient-Help.com — free, confidential, within 24 hours.

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How to Choose a Hospital in Bangalore

1. NABH accreditation — Confirms the hospital meets national quality and safety standards.
2. Skull base surgery experience — Acoustic neuroma surgery is highly specialised. Ask how many cases the team performs each year.
3. Intraoperative facial nerve monitoring — Essential to protect the facial nerve during surgery.
4. Multidisciplinary team — Neurosurgeon, ENT surgeon, and audiologist working together.
5. Gamma Knife availability — For patients who prefer radiosurgery, confirm the hospital has this technology.

Patient-Help.com matches you with verified specialists in Bangalore — free of charge.

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Frequently Asked Questions

Is acoustic neuroma life-threatening?

Acoustic neuroma is a benign (non-cancerous) tumour. It does not spread to other parts of the body. However, large untreated tumours can press on the brainstem and become life-threatening. Most patients who receive appropriate treatment do very well.

Will I lose my hearing after surgery?

Hearing outcome depends on the surgical approach and the tumour's size. The translabyrinthine approach results in complete hearing loss on the operated side. The retrosigmoid and middle fossa approaches offer a chance of hearing preservation. Radiosurgery preserves hearing in 50 to 70% of patients.

What is the difference between surgery and Gamma Knife?

Surgery removes the tumour completely. Gamma Knife (stereotactic radiosurgery) delivers targeted radiation to stop the tumour from growing — it does not remove it. Surgery is preferred for large tumours or those causing brainstem compression. Gamma Knife is preferred for small tumours in older patients or those who want to avoid surgery.

How long does recovery take after acoustic neuroma surgery?

Most patients return to light daily activities within 4 to 6 weeks. Balance problems may persist for 2 to 3 months as the brain adapts. Return to full work typically takes 2 to 3 months.

Can acoustic neuroma come back after treatment?

After complete surgical removal, recurrence is rare (less than 5%). After radiosurgery, the tumour may continue to grow slowly in 5 to 10% of cases, requiring further treatment. Regular MRI follow-up is recommended for all patients.

Is acoustic neuroma hereditary?

Most acoustic neuromas are not hereditary. Bilateral acoustic neuromas are associated with neurofibromatosis type 2 (NF2), a rare genetic condition. If you have a family history of NF2 or bilateral acoustic neuromas, genetic counselling is recommended.

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Ready to find the right specialist for acoustic neuroma treatment in Bangalore? Submit your details on Patient-Help.com and receive a free, confidential match with verified specialists — within 24 hours.

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Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified specialist before making any healthcare decisions. Patient-Help.com connects patients with verified hospitals and doctors but does not provide medical diagnoses or treatment recommendations.

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Sources

1. Acoustic Neuroma — Overview — Mayo Clinic
2. Vestibular Schwannoma — Patient Information — AANS (American Association of Neurological Surgeons)
3. Epidemiology and management of vestibular schwannoma — NCBI PubMed