Acoustic Neuroma
Definition
Acoustic neuroma, also known as vestibular schwannoma, is a benign tumor that grows on the cranial nerve running from the brain to the inner ear.
Types
- Unicentric (single tumor)
- Multicentric (multiple tumors)
- Intracanalicular (within the internal auditory canal)
- Extracanalicular (outside the internal auditory canal)
- Cystic (fluid-filled)
- Solid (non-fluid-filled)
Causes
- Genetic: Associated with neurofibromatosis type 2 (NF2)
- Environmental: Exposure to ionizing radiation
- Unknown: Most cases are sporadic and of unknown cause
Pathology
- Origin: From Schwann cells, which cover and protect Cranial Nerve VIII (Vestibulocochlear nerve)
- Microscopic: Composed of Schwann cells, fibroblasts, and capillaries
- Growth: Slow-growing, usually asymptomatic until large enough to cause symptoms
Clinical Features
- Hearing loss: Gradual loss of hearing, usually in one ear
- Tinnitus: Ringing or other sounds in the ear
- Balance problems: Dizziness or loss of balance
- Facial weakness: Weakness or numbness of the face
- Headache: Pain in the head, often on one side
- Cranial nerve involvement: Other cranial nerves may be affected, depending on the size and location of the tumor
Investigations
- Imaging: MRI or CT scan to confirm the diagnosis and assess the size and location of the tumor
- Audiometry: Tests to assess hearing and balance
- Electronystagmography: Tests to assess eye movements and balance
Complications
- Hearing loss: Permanent loss of hearing in one or both ears
- Balance problems: Persistent dizziness or loss of balance
- Facial weakness: Permanent weakness or numbness of the face
- Cranial nerve involvement: Other cranial nerves may be affected, leading to a range of symptoms
Management
- Surgery: Microsurgical removal of the tumor
- Radiosurgery: Focused radiation to shrink the tumor
- Observation: Monitoring with regular imaging and audiometry for slow-growing tumors
- Conservative management: Managing symptoms and monitoring for complications
Homoeopathic Therapeutics
- Aconitum napellus: For sudden onset of symptoms, such as hearing loss or balance problems
- Belladonna: For symptoms such as tinnitus, headache, or facial weakness
- Calcarea carbonica: For gradual onset of symptoms, such as hearing loss or balance problems
- Graphites: For symptoms such as tinnitus, headache, or facial weakness
- Hydrastis canadensis: For symptoms such as balance problems or facial weakness
- Kali carbonicum: For symptoms such as tinnitus, headache, or facial weakness
- Pulsatilla: For symptoms such as hearing loss or balance problems
- Sepia: For symptoms such as tinnitus, headache, or facial weakness
- Silica: For symptoms such as hearing loss or balance problems
- Sulfur: For symptoms such as tinnitus, headache, or facial weakness