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Acoustic Neuroma
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Ear Nose Throat

Acoustic Neuroma

An acoustic neuroma is a benign, slow-growing tumor on the nerve connecting the ear to the brain that can impact hearing, balance, and facial function.

Overview

An acoustic neuroma is a benign tumor that develops on the nerve that connects the ear to the brain. The tumor usually grows slowly. As it grows, it presses against the hearing and balance nerves. At first, you may have no symptoms or mild symptoms.

Symptoms

Early symptoms can include:

  • Loss of hearing on one side
  • Ringing in ears
  • Dizziness and balance problems

The tumor can also eventually cause numbness or paralysis of the face. If it grows large enough, it can press against the brain, becoming life-threatening.

Causes & Risk Factors

If the tumors affect both hearing nerves, it is often because of a genetic disorder called neurofibromatosis.

Diagnosis

Acoustic neuroma can be difficult to diagnose, because the symptoms are similar to those of middle ear problems. Ear exams, hearing tests, and scans can show if you have it.

Treatment & Management

If the tumor stays small, you may only need to have it checked regularly. If you do need treatment, surgery and radiation are options.

Frequently Asked Questions

MRI with gadolinium contrast provides superior soft-tissue resolution, allowing doctors to clearly visualize the small nerve fibers and the tumor itself, even when it is very small (less than 1 cm). CT scans are excellent for viewing bone structures but often miss small acoustic neuromas because the tumor and the surrounding nerve tissue have similar densities. An MRI can detect tumors as small as 2 to 3 millimeters, which is critical for early intervention and monitoring.
For small, slow-growing tumors in older patients or those with minimal symptoms, doctors may recommend active surveillance instead of immediate surgery. This involves regular MRI scans, typically every 6 to 12 months for the first few years, to monitor the tumor's size and growth rate. If the tumor remains stable and does not press against the brainstem or cause significant hearing loss, this approach avoids the risks of surgery and radiation while maintaining quality of life.
In patients with NF2, acoustic neuromas are often bilateral (affecting both ears) and may develop at a younger age. Because these patients are at risk for developing multiple tumors over their lifetime, the treatment strategy focuses on preserving hearing for as long as possible. Doctors may opt for stereotactic radiosurgery (like Gamma Knife) rather than open surgery to minimize damage to the facial nerve and hearing, reserving surgery for cases where the tumor causes significant mass effect or rapid growth.
Yes, as the tumor grows, it can compress the facial nerve (cranial nerve VII), leading to weakness or paralysis on one side of the face. In many cases, if the compression is relieved through surgery or radiation, facial function can improve or recover, though full recovery depends on the duration and severity of the nerve damage. Early treatment is often recommended to prevent permanent facial nerve dysfunction.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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