Acoustic Neuroma: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Acoustic Neuroma?
A neurosurgeon (a brain and nerve surgeon) or an ear, nose, and throat doctor usually treats acoustic neuroma. An audiologist (a hearing expert) helps with hearing tests. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is acoustic neuroma?
An acoustic neuroma, also called a vestibular schwannoma, is a benign (not cancer) tumor. It is usually slow-growing. The tumor develops from the balance and hearing nerves that supply the inner ear. It comes from an overproduction of Schwann cells, the cells that wrap around nerve fibers to support and insulate them.
The tumor does not spread to other parts of the body. But as it grows, it can damage nearby nerves and press on brain structures.
Symptoms
As the tumor grows, it affects the hearing and balance nerves. This usually causes hearing loss in one ear, or hearing that is worse in one ear. Other common signs are tinnitus (ringing in the ear) and dizziness or loss of balance.
Other symptoms can include:
- Facial numbness, when the tumor interferes with the trigeminal nerve (the nerve for face feeling).
- Facial weakness on the side of the tumor, if it affects the facial nerve.
- Headache, or pain in the face or one ear.
- Trouble understanding speech.
Symptoms may be easy to miss at first. Hearing loss, dizziness, and tinnitus can have many causes. One-sided symptoms are the worrisome ones.
Causes and who gets it
Scientists believe these tumors form after a gene on chromosome 22 stops working well. This gene makes a protein that controls how Schwann cells grow. When the gene goes wrong, Schwann cells grow too fast and a tumor forms.
Most acoustic neuromas in one ear do not run in families. They happen by chance. Symptoms can appear at any age but usually occur between the ages of 30 and 60 years. Acoustic neuromas are uncommon.
Tumors in both ears are usually linked with neurofibromatosis type 2 (NF2). NF2 is a genetic disorder that often causes several tumors in the brain and spinal cord. Half of affected people inherited NF2 from a parent.
How doctors diagnose it
The doctor checks your ears and tests your hearing and balance to make the diagnosis. Testing includes an audiogram (a hearing test) and tests of balance and hearing pathways.
An MRI scan (magnetic resonance imaging) makes detailed pictures of the brain with a strong magnet. It finds the tumor early and shows its size and place. The physical exam is often normal when the tumor is found.
Treatment
There are three options for managing an acoustic neuroma: surgical removal, radiation, and observation (watching the tumor for growth). When the tumor is small and not growing, it may be reasonable to watch it. MRI scans are used to carefully monitor the tumor for any growth.
Surgery is more commonly done for larger tumors, tumors that are causing symptoms, tumors that are growing quickly, or tumors that are pressing on the brain. The exact operation depends on the size of the tumor and the level of hearing in the affected ear.
Stereotactic radiosurgery aims high-powered x-rays at a small area. It is radiation therapy, not surgery. It may slow down or stop the growth of tumors that are hard to remove with surgery.
Removing the tumor can damage the hearing, balance, or facial nerves. This may cause hearing loss or weakness in the face muscles. This damage is more likely when the tumor is large. After radiosurgery, signs of nerve damage like hearing loss or facial weakness may be delayed.
When to see a doctor
Contact your doctor if you have hearing loss that is sudden or getting worse, ringing in one ear, or dizziness. If a tumor becomes large, it can press on nearby brain structures and become life-threatening. A large tumor can sometimes cause a build-up of fluid in the brain (hydrocephalus), but this is rare. Call 911 right away for sudden weakness (including in the face), trouble speaking, a sudden change in vision, fainting, or confusion or trouble waking up.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. This kind of doctor can check your hearing and balance, order an MRI, and refer you to a neurosurgeon or an ear, nose, and throat doctor for treatment.
Common questions
Is an acoustic neuroma cancer?
No. It is a benign tumor, so it does not spread to other parts of the body. But it may keep growing and press on structures in the skull.
Will I need surgery?
Not always. When the tumor is small and not growing, it may be reasonable to watch it with MRI scans. Surgery is more commonly done for larger tumors, tumors causing symptoms, or tumors growing quickly.
Can hearing come back after 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.
Can acoustic neuromas run in families?
Most tumors in one ear are not hereditary. Tumors in both ears are usually linked with neurofibromatosis type 2 (NF2), and half of affected people inherited NF2 from a parent.
Sources
- MedlinePlus - Acoustic neuroma
- National Institute on Deafness and Other Communication Disorders - Vestibular Schwannoma (Acoustic Neuroma) and Neurofibromatosis
- NHS - Acoustic neuroma (vestibular schwannoma)
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
