An acoustic neuroma is a slow-growing
of the nerve that connects the ear to the brain. This nerve is called the vestibular cochlear nerve. It is behind the ear, right under the brain.
An acoustic neuroma is a
tumor. This means that it does not spread to other parts of the body. However, it can damage several important nearby nerves as it grows.
Acoustic neuromas have been linked with the genetic disorder
(NF2).
Acoustic neuromas are uncommon.
The symptoms vary, based on the size and location of the tumor. Because the tumor grows so slowly, symptoms most often start after age 30.
Common symptoms include:
Abnormal feeling of movement (
)
in the affected ear that makes it hard to hear conversations
Ringing (
) in the affected ear
Less common symptoms include:
Difficulty understanding speech
Dizziness
Headache
Loss of balance
in the face or one ear
or one ear
or facial asymmetry
The health care provider may suspect an acoustic neuroma based on your medical history, an exam of your nervous system, or tests.
Often, the physical exam is normal when the tumor is diagnosed. Sometimes, the following signs may be present:
Decreased feeling on one side of the face
on one side of the face
The most useful test to identify an acoustic neuroma is an
. Other tests to diagnose the tumor and tell it apart from other causes of dizziness or vertigo include:
Hearing test
Test of equilibrium and balance (
)
Test of hearing and brainstem function (brainstem auditory evoked response)
The treatment depends on the size and location of the tumor, your age, and your overall health. You and your provider must decide whether to watch the tumor without treatment, use radiation treatment to stop it from growing, or try to remove it.
Many acoustic neuromas are small and grow very slowly. Small tumors with few or no symptoms may be watched for changes, especially in older people. Regular MRI scans will be done.
If not treated, some acoustic neuromas can:
Damage the nerves involved in hearing and balance
Place pressure on nearby brain tissue
Harm the nerves responsible for movement and feeling in the face
Lead to a buildup of fluid (
) in the brain (only with very large tumors)
Removing an acoustic neuroma is more commonly done for:
Larger tumors
Tumors that are causing symptoms
Tumors that are growing quickly
Tumors that are pressing on the brain
Surgery or a type of radiation treatment is done to treat the tumor and prevent other nerve damage. Depending on the type of surgery performed, hearing can sometimes be preserved.
The surgical technique to remove an acoustic neuroma is called microsurgery. A special microscope and small, precise instruments are used. This technique offers a higher chance of cure.
focuses high-powered x-rays on a small area. It is a form of radiation therapy, not a surgical procedure. It may be used to slow down or stop the growth of tumors that are hard to remove with surgery. It may also be done to treat people who are unable to have surgery, such as older adults or people who are very sick.
Removing an acoustic neuroma can damage the acoustic or other nerves. This may cause loss of hearing or weakness in the face muscles. This damage is more likely to occur when the tumor is large.
An acoustic neuroma is not cancer. The tumor does not spread to other parts of the body. However, it may continue to grow and press on structures in the skull.
People with small, slow-growing tumors may not need treatment.
Hearing loss that is present before treatment is not likely to return after surgery or radiosurgery. In cases of smaller tumors, hearing loss that occurs after surgery may return.
Most people with small tumors will have no permanent weakness of their face after surgery. However, people with large tumors are more likely to have some permanent weakness of the face after surgery.
Signs of nerve damage such as loss of hearing or weakness of the face may be delayed after radiosurgery.
In most cases, surgery can completely remove the tumor.
Contact your provider if you have:
Hearing loss that is sudden or getting worse
Ringing in one ear
Dizziness (vertigo)
Vestibular schwannoma; Tumor - acoustic; Cerebellopontine angle tumor; Angle tumor; Hearing loss - acoustic; Tinnitus - acoustic
Central nervous system and peripheral nervous system
Arriaga MA, Ying Y-LM. Neoplasms of the posterior fossa. In: Francis HW, Haughey BH, Hillel AT, et al, eds. Cummings Otolaryngology. 8th ed. Philadelphia, PA: Elsevier; 2026:chap 176.
Doyle EJ, Hertzano R, Tucci D, Samy RN. Sensorineural hearing loss in adults. In: Francis HW, Haughey BH, Hillel AT, et al, eds. Cummings Otolaryngology. 8th ed. Philadelphia, PA: Elsevier; 2026:chap 150.
Mellinghoff IK, DeAngelis LM. Tumors of the central nervous system. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 175.
Updated by: Ashutosh Kacker, MD, FACS, Professor of Clinical Otolaryngology, Weill Cornell Medical College, and Attending Otolaryngologist, New York-Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.