The most common acoustic neuroma (vestibular schwannoma) symptoms include hearing loss affecting one ear, tinnitus in one or both ears, dizziness or vertigo, balance problems, facial pain and persistent headaches.
These symptoms usually develop as the tumour grows and puts pressure on the acoustic nerve or nearby nerves. That matters because symptoms often begin in ways that feel specific to the ear, hearing or coordination, rather than as a more general neurological problem.
Learn more about the symptoms of acoustic neuroma (vestibular schwannoma) and research that Brain Tumour Research funds on this tumour type in this explainer.
What is an acoustic neuroma (vestibular schwannoma)?
An acoustic neuroma (vestibular schwannoma) is an example of a schwannoma – a type of low-grade brain tumour that develops on nerves. Schwannomas can develop on nerves throughout the body, but in the case of acoustic neuroma (vestibular schwannoma) the tumour develops on the nerve responsible for hearing and balance, known as the vestibulocochlear nerve. It is for this reason that acoustic neuroma (vestibular schwannoma) is also known as vestibular schwannoma.
Schwannoma tumours develop from Schwann cells that line and insulate nerves throughout the body. In vestibular schwannoma, it wraps around the vestibulocochlear nerve, or auditory, nerve in the inner ear. Because that nerve helps carry messages linked to hearing, balance and body position, symptoms often show up as hearing and balance changes.
What are the most common acoustic neuroma (vestibular schwannoma) symptoms?
Acoustic neuroma (vestibular schwannoma) symptoms may include one or more of the following:
- Hearing loss that becomes gradually worse, usually affecting one ear
- Tinnitus, often described as a buzzing or ringing noise in one ear
- Facial muscle weakness, numbness or pain
- Dizziness or vertigo
In the case of larger tumours, symptoms may also include;
- Persistent headaches
- Balance issues, particularly when walking in the dark or on uneven ground
- Poor limb co-ordination on one side of the body
Not everyone will experience the same pattern. Some people may first notice a hearing change in one ear. Others may become more aware of dizziness, imbalance or facial symptoms. The symptoms can also build slowly, which may make them harder to describe clearly at first.
Why do acoustic neuroma (vestibular schwannoma) symptoms often affect hearing and balance?
Acoustic neuroma (vestibular schwannoma) symptoms often affect hearing and balance because the tumour grows on the nerve linked to those functions.
Symptoms develop when the tumour grows to the point where it puts pressure on the acoustic nerve or nearby nerves. That pressure can affect hearing, balance, facial movement and facial sensation. It may also affect nearby blood vessels or other structures within the brain.
This helps explain why one-sided hearing loss, tinnitus, dizziness and balance problems are so common in people with acoustic neuroma (vestibular schwannoma). These tumours do not cause the same symptoms in every patient, but the hearing and balance pathway often sits at the centre of the symptom picture.
Can acoustic neuroma (vestibular schwannoma) symptoms change over time?
Yes. Hearing loss linked to acoustic neuroma (vestibular schwannoma) often becomes gradually worse, although it can occasionally worsen suddenly. Hearing loss may also fluctuate.
That gradual change matters because symptoms do not always arrive in one clear step. A person may notice hearing becoming less sharp on one side, then begin to experience tinnitus, dizziness or balance problems later. Someone else may first notice a feeling of unsteadiness, particularly in the dark or on uneven ground.
As the tumour grows, it can place more pressure on nearby nerves and structures. That can lead to a broader symptom picture, including facial weakness, numbness, pain or poor limb co-ordination on one side of the body.
Acoustic neuroma (vestibular schwannoma) may be low-grade, but it can still have a serious effect on hearing, balance and facial function over time. Brain Tumour Research funds the long-term research needed to improve treatments and move closer to cures.
Can acoustic neuroma (vestibular schwannoma) symptoms affect the face as well as the ear?
Yes. Acoustic neuroma (vestibular schwannoma) symptoms can affect the face as well as the ear.
The tumour may press on adjacent nerves, including the facial nerve, which controls facial muscles, and trigeminal nerves, which influence sensation in the face. That is why some people experience facial muscle weakness, facial numbness or facial pain as part of the symptom pattern.
This is one reason acoustic neuroma (vestibular schwannoma) should not be understood only as a hearing-related tumour. It often begins with hearing and balance symptoms, but it can affect a wider range of functions as it grows.
Is acoustic neuroma (vestibular schwannoma) a low-grade brain tumour?
Almost all acoustic neuromas (vestibular schwannoma) are classified as grade 1, non-cancerous tumours - the slowest-growing type of tumour.
A low-grade tumour such as acoustic neuroma (vestibular schwannoma), while not cancerous, can still cause serious and disruptive symptoms over time as it increases in size. In acoustic neuroma (vestibular schwannoma), symptoms often become more noticeable because the tumour continues to press on nerves linked to hearing, balance and facial function.
Acoustic neuroma (vestibular schwannoma) tumour is rare, with the risk increasing as you age. Some tumours are caused by a rare genetic condition called NF2-related schwannomatosis (formerly known as neurofibromatosis type 2) which causes multiple non-cancerous tumours of the brain and spinal cord, and vestibular schwannomas on both sides of the head.
What treatment is available for acoustic neuroma (vestibular schwannoma)?
Treatment depends on the size, position and how fast the tumour is growing.
Some acoustic neuromas (vestibular schwannoma) grow so slowly that clinicians monitor them with regular scans and may not treat them straight away. Others may grow more quickly or are diagnosed at a larger sizer and need earlier treatment.
Many acoustic neuromas (vestibular schwannoma) are treated with surgery. Neurosurgeons will remove all or part of the tumour depending on its size and location. Surgery may result in further damage to the vestibulocochlear nerve around which the tumour is wrapped, this will be discussed with patients prior to surgery.
Targeted (stereotactic) radiotherapy may be used for small acoustic neuromas (vestibular schwannoma) or larger pieces of tumour that remain after surgery, depending on their position. This is the use of x-rays to stop the tumour growing or reduce it in size.
Chemotherapy is not used in the treatment of acoustic neuromas/vestibular schwannoma.
Why does research into acoustic neuroma (vestibular schwannoma) matter?
Research matters because acoustic neuroma (vestibular schwannoma) is a low-grade brain tumour that can have a serious impact on hearing, balance, facial function and daily life.
Work funded across its Centres of Excellence will help lead towards finding a cure for a wide range of brain tumours.
The Brain Tumour Research Centre of Excellence at the University of Plymouth is one of Europe’s leading research institutes for low-grade brain tumours, with research focused on schwannoma and NF2-related tumours, which include acoustic neuroma (vestibular schwannoma).
We fund the research infrastructure and scientific progress needed to improve treatments and move closer to cures.
Understanding acoustic neuroma (vestibular schwannoma) symptoms and supporting research
Acoustic neuroma (vestibular schwannoma) symptoms often begin with hearing loss, tinnitus, dizziness or balance problems, but they can also include facial weakness, numbness, pain, headaches or poor co-ordination. The exact pattern depends on how the tumour affects the acoustic nerve and nearby nerves.
Brain tumours remain underfunded Brain Tumour Research is the only national charity focused on finding a cure for all types of brain tumours. By funding long-term research and campaigning for increased national investment, the Charity aims to improve treatments and move closer to cures.
If you want to support the research that helps improve treatments and move closer to cures, you can donate to Brain Tumour Research, fundraise, campaign or help raise awareness of the need for sustained investment in brain tumour research.
Medical disclaimer
This information is for general awareness and educational purposes only. It does not constitute medical advice. If you are experiencing symptoms mentioned here, or have concerns about your health, contact your GP or a qualified medical professional for advice and assessment.
References used
Brain Tumour Research. Acoustic Neuroma (Vestibular Schwannomas). https://braintumourresearch.org/pages/types-of-brain-tumours-acoustic-neuroma
Brain Tumour Research. University of Plymouth | Centres of Excellence. https://braintumourresearch.org/pages/centres-of-excellence-university-of-plymouth