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Can An Acoustic Neuroma Cause Neck Pain

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How Does An Acoustic Neuroma Affect People

Do Acoustic Neuromas Cause Pain?

The tumor can cause symptoms most commonly by affecting hearing or balance functions. More than 90% of acoustic neuromas affect the hearing nerve in one ear, which is called unilateral hearing loss.

An acoustic neuroma can also press on nerves that control your facial movement, sensation and expression. Large tumors that press on brain structures that control the flow of spinal fluid out of the brain can be life-threatening.

Disabling Physical Symptoms Of An Acoustic Neuroma

Physical symptoms of an acoustic neuroma may vary in severity and fluctuate over time, with some days or weeks being much worse than others. Physical symptoms may include:

  • Hearing loss
  • Tinnitus
  • Feeling of pressure or fullness in the ears
  • Vertigo

It is important to document all of your symptoms with your treating doctor.

What Causes Acoustic Neuroma

Most acoustic neuromas are caused by a malfunctioning chromosome 22, meaning that the condition is genetic. It appears that the tumor arises as a result of the loss of a tumor-suppressor gene on the long arm of chromosome 22. The annual incidence is 0.78-1.15 cases per 100,000 population, resulting in approximately 2280 new cases per year in the US. Patients usually become symptomatic after age 30. The incidence of acoustic neuromas is increased in neurofibromatosis with bilateral acoustic neuromas being a characteristic of neurofibromatosis type 2.

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Diagnosis Of Acoustic Neuromas

Diagnosis begins with an audiogram. The hearing ability of each ear is evaluated. The evaluation may indicate loss of hearing and speech discrimination.

Imaging techniques such as magnetic resonance imaging, or MRI, and computed tomography, or CT, scan can highlight acoustic tumors. MRI is preferred because it can clearly define acoustic neuromas, even if they are small.

An auditory brainstem response, or ABR, test may also be performed. An abnormal result of the ABR test can imply possible diagnosis of acoustic neuroma. However, an abnormal result of this test should be confirmed by a subsequent MRI.

What Is Recovery From Acoustic Neuroma Surgery Like

Acoustic Neuroma

The recovery time after surgery depends on the patients overall health prior to and after surgery. Routine hospitalization can usually range anywhere between three and five days after surgery. Immediately following surgery, patients can expect to stay one to two days in the Intensive Care Unit and two to three days on a hospital floor with specialized neuro trained nurses and physician assistants.

An important part of surgery for the removal of an acoustic neuroma is preserving the functionality of the facial nerve. While the facial nerve controls facial movement, it is also responsible for closing the eyelid. Closing the eyelid is so important because doing so protects the eye and specifically the cornea. If the cornea is not protected, it can lead to a cornea ulcer and potential blindness.

After surgery, if the facial nerve is not working and cannot close the eyelid completely, a plastic surgeon may complete a temporary procedure where a gold or platinum weight is surgically placed into the upper eyelid to give the eyelid more mass to close fully. Neuro-Ophthalmologists are also a part of the multidisciplinary team approach here at the Neurosciences Center and will be part of your care after surgery to ensure the eye is cared for properly .

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Acoustic Neuroma Treatment And Surgery

If the tumor is small and is not causing symptoms, the only treatment necessary may be monitoring with hearing tests and MRI scans every six months to make sure that the tumor has not grown. If the tumor does cause symptoms, treatment is usually indicated to prevent further problems. Treatment options generally include surgery, radiation therapy, or radiosurgery, a non-invasive or knifeless procedure that uses precision high dose radiation. Open acoustic neuroma surgery is generally reserved for very large tumors that significantly compress the brainstem, an adjacent critical structure. In some cases, significant compression of the brainstem can be a life threatening situation. Fortunately, non-invasive techniques using radiosurgery can be used to stop further growth when tumors are detected before significant growth occurs. Therefore, it is helpful if these lesions are detected early. If you have questions about acoustic neuroma treatment, please contact us.

How Is An Acoustic Neuroma Treated

The goal of treatment is to stop the degeneration of surrounding cranial nerves. If you are a candidate for hearing preservation, the goal is to preserve your hearing to the level it is at when you are first diagnosed, but it does not recover your hearing to a prior state. Maintaining facial nerve function and drastically minimizing the need for any future treatment is a top priority.

Depending on the size of the tumor, the age and medical condition of the patient, various procedures may be done.

Microsurgery

Surgery is performed in an operating room where a skull-base surgical team uses the latest microsurgical approaches and equipment. There are three main microsurgical approaches for the removal of an acoustic neuroma. The approach used for each individual patient is based on factors such as tumor size, location, skill and experience of the surgeon. The surgeon and the patient should thoroughly discuss the reasons for a selected approach.

Radiosurgery

With radiosurgery, the goal is to stop the growth of your tumor without injuring important structures around the tumor. This does not lead to removal of the tumor but may potentially stop further growth or shrink it over time. Radiosurgery is generally reserved for tumors under 2.5 cm in diameter. For young, healthy candidates with active lifestyles and a desire to preserve their hearing, surgery, as opposed to radiation, is often recommended.

Watch and Wait or Observation

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Can The Surgeon Preserve My Hearing

Your surgeon monitors your hearing during surgery to increase the chances of hearing preservation.

People with large tumors that have seriously affected hearing have a lower chance of preserved hearing. About 50% of people who have small to medium tumors and good hearing before surgery will hear in that ear after surgery.

What Are Causes Of An Acoustic Neuroma

How Will Acoustic Neuroma Treatment Affect My Balance?

The most frequent and earliest symptom of an acoustic neuroma is hearing loss, though headaches are also common. Hearing loss is caused by the pressure the lesion exerts on the acoustic nerve.

The hearing loss is on the side of the head where the tumor is present, while the other side is unaffected. The hearing loss often progresses slowly at first however, in some cases it can be quite rapid. Other symptoms can include tinnitus or ringing in the ear, dizziness, and balance difficulty. If the tumor is large it may also cause facial numbness or weakness, and on rare occasions patients complain of headaches.

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The Most Common Symptoms Of A Brain Tumor

Brain tumors occur when abnormal cells accumulate in the brain. They can be cancerous or unlikely to spread . Since there is a limited amount of space in the brain, even a non-cancerous tumor can cause multiple problems. Brain tumors can interfere with brain and body function, increase inflammation, elevate skull pressure, and destroy brain cells, which leads to neurodegenerative disease. Tumors can form from cells directly in your brain or from cells in other parts of your body. Look for these common symptoms that everyone should be aware of now.

What Are The Possible Complications From The Treatments For Acoustic Neuroma

  • Damage to the facial nerve, causing a facial nerve palsy. The facial nerve is the nerve in the brain that controls movements in the muscles of the face. If an acoustic neuroma has grown quite large, removal during surgery can potentially lead to damage of this neighbouring nerve. If the nerve is damaged, there will be paralysis of part of the face. This can cause a problem with drooping of one side of the face. In some cases, physiotherapy will help but, in others, the damage is permanent. Obviously, during surgery, great care is taken to identify and avoid damage to surrounding nerves.
  • Damage to the vestibulocochlear nerve, leading to deafness. As mentioned, a degree of hearing loss is normal after treatment for acoustic neuroma. If you have NF2 and bilateral tumours, there is a strong chance that after surgery, you will completely lose the hearing in both of your ears.
  • Damage to the trigeminal nerve, leading to loss of feeling . In the same way that the facial nerve can be damaged during surgery to remove an acoustic neuroma, the trigeminal nerve can also be injured. If this occurs, there is loss of sensation to parts of the face.

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Treatments For Acoustic Neuromas

There are several different treatment options for an acoustic neuroma, depending on the size and position of your tumour, how fast it’s growing and your general health.

The main options are:

  • monitoring the tumour small tumours often just need to be monitored with regular MRI scans, and the treatments below are generally only recommended if scans show it’s getting bigger
  • brain surgery surgery to remove the tumour through a cut in the skull may be carried out under general anaesthetic if it’s large or getting bigger
  • stereotactic radiosurgery small tumours, or any pieces of a larger tumour that remain after surgery, may be treated with a precise beam of radiation to stop them getting any bigger

All these options carry some risks. For example, surgery and radiosurgery can sometimes cause facial numbness or an inability to move part of your face .

Speak to your specialist about the best option for you and what the benefits and risks are.

Salivary Gland Cancer Symptoms

Acoustic Neuroma: 10 Symptoms of a Acoustic Neuroma

Salivary glands make saliva and release it into the mouth. There are three major salivary glands:

  • Parotid glands

Symptoms for this type of cancer may include:

  • Painless lump in your ear, cheek, jaw, lip or inside of the mouth
  • Fluid draining from your ear
  • Trouble swallowing or opening mouth wide
  • Numbness or weakness in your face
  • Persistent pain in your face

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Twitching In The Face

Very rare cause: acoustic neuroma. These benign tumors overall are rare, and their more common symptoms include hearing loss and/or tinnitus in one ear, pain in the ear, balance problems, dizziness, headache, numbness or weakness in the facial muscles, eye problems and swallowing difficulties. A person may have only a few of these symptoms.

TMJ disorder: another rare cause.

Benign fasciculation syndrome: not rare but not common cause of facial twitching.

Stress, not enough sleep, fatigue, too much caffeine, dehydration: common causes.

The definition of twitch in the face is also open to interpretation.

Theres the type of twitching at any location of the face thats the same kind that affects an eyelid.

Then theres the so-called tic type of twitch, which can be caused by Tourettes syndrome or just an odd habit.

Usually, a twitch in the face is nothing to worry about. But if these twitches began appearing at around the same time as the symptoms of acoustic neuroma , this is more suggestive of this benign growth.

However, according to a paper in the American Journal of Otology, some of the symptoms of a facial nerve mass can mimic an acoustic neuroma.

The growth can occur at any point along the facial nerve. An MRI will be ordered when a doctor suspects either condition.

Acoustic Neuroma And Ear Pain

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Chordomas In The Clivus And Upper Cervical Spine

A chordoma is a rare type of tumor. Sometimes, these tumors occur on a bone in skull base called the clivus. Others occur on the upper cervical spine .

Chordomas are caused by cells associated with a structure called the notochord. The notochord is involved in fetal development of the spine and nerve system. Typically, notochord cells disappear from the body before birth, but they sometimes remain in the body through adulthood. When this happens, notochord cells can sometimes grow out of control, forming a chordoma.

Chordomas are most common in adults age 40-60. There are often no noticeable symptoms. However, some patients experience symptoms such as:

  • Weakness
  • Numbness
  • Changes in mobility

Chordomas in the clivus and upper cervical spine often create problems by crowding other structures in the body, including the brain and spinal cord. These growths are frequently treated with a combination of both skull base surgery and radiation.

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How Are Acoustic Neuromas Diagnosed

You’ve got an Acoustic Neuroma.

Because symptoms of acoustic neuromas resemble other middle and inner ear conditions, they may be difficult to diagnose. Preliminary diagnostic procedures include an ear examination and a hearing test. Computerized tomography and magnetic resonance imaging scans help to determine the location and size of the tumor.

Early diagnosis offers the best opportunity for successful treatment.

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What Are Symptoms Of Acoustic Neuroma

Not everyone with an acoustic neuroma will experience symptoms. Benign tumors typically grow very slowly, including acoustic neuromas. Symptoms depend on the location of the tumor along the vestibulocochlear nerve and may take years to develop. This is why acoustic neuromas are typically diagnosed in patients30-60 years old.

Unilateral hearing loss is the first symptom in90% of people diagnosed with an acoustic neuroma. This means only one ear is affected, as acoustic neuromas typically only form on one of the two nerves. The hearing loss may be subtle at first and develop over time, but it can also occur suddenly. Other common symptoms include tinnitus , dizziness and vertigo, difficulty with balance and headaches.

If your acoustic neuroma impinges on other cranial nerves, you may experience symptoms related to their function. Pressure on the optic nerve can affect vision. Likewise, if the facial nerve is affected, facial muscle weakness or numbness can result. Sometimes an acoustic neuroma can block the natural flow of cerebrospinal fluid, leading to a buildup of fluid on the brain called hydrocephalus.

Are Acoustic Neuromas Dangerous

Many acoustic neuromas do not grow, and though not always, most that do grow tend to do so slowly. They typically do not invade and destroy tissue like cancerous tumors do. However, they can cause symptoms as they grow and push on important surrounding structures.

A growing acoustic neuroma can cause compression of the nerves that enable facial sensation and movement of the facial muscles. With larger tumors, compression of the nerves important for swallowing, speaking and eye movement can occur.

Even if acoustic neuroma is not growing, it can cause worsening hearing loss and balance function.

If a growing acoustic neuroma is left untreated, it can cause a dangerous buildup of fluid in the brain or it can compress the cerebellum and brain stem, which can be life threatening. This is rare for patients whose tumors are properly diagnosed and treated.

Acoustic Neuroma Survival Rate

Though acoustic neuromas can cause lasting problems, such as hearing loss, death from these tumors is rare if they are properly diagnosed and treated.

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What Is The Outlook

The outlook is generally very good. Acoustic neuromas usually respond well to treatment and complications are uncommon. However, there is often some hearing loss in the affected ear after treatment.

Fewer than 5 in every 100 acoustic neuromas come back. So it is uncommon, but possible. It is more likely if you have NF2. It could cause any of the symptoms mentioned earlier, or any of the complications. After treatment for acoustic neuroma you will generally be followed up in an outpatient clinic to check for any symptoms or signs of it coming back.

Proof Of Inability To Work Due To An Acoustic Neuroma

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Without question, the symptoms of an acoustic neuroma can be extremely disabling. However, you should never assume that the insurance company will understand how your symptoms impact your job. To increase your chances of approval, you must explain why each of your symptoms prevents you from performing your job duties.

For example, hearing loss may make it very hard to understand people during conversations or while on the phone. Severe hearing loss may even prevent you from effectively communicating with others at work.

Vestibular and balance issues may make it difficult to commute and safely navigate your work environment. Severe vestibular and balance issues may even impair your ability to perform a desk job simple tasks like bending to get a file out of desk drawer or getting up from your chair may be unsafe or exacerbate your symptoms. At times, you may not even be able to lift your head without exacerbating your symptoms further.

Many people also find it difficult to concentrate and focus at work due to fatigue, tinnitus, and chronic headaches. You may even find that you are performing work tasks much slower. This can be particularly troublesome if your job requires rapid responses or higher level cognitive functioning.

Explain how your individual symptoms prevent you from performing your job duties by preparing a written narrative for the insurance company. Make sure that your narrative addresses all of your symptoms by listing them separately first.

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What Are Surgical Options For An Acoustic Neuroma

The advantages of the surgical removal of acoustic neuromas are twofold. The first benefit to surgery is the advantage of a pathologic diagnosis. By removing the tumor, neuropathologists are able to examine and conduct a number of genetic tests on the tumor tissue to determine the variant of the tumor and learn more about its origin. The other advantage of surgery is that the acoustic neuroma is completely removed. Once taken out, the chances of an acoustic neuroma recurring are greatly diminished.

There are three approaches to the surgical removal of an acoustic neuroma. The best option will be determined by a number of factors, including the patients overall health:

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