“Tuning out” is a frustrating habit that long-time couples develop over time. But what if your “selective hearing” actually signals a serious health condition?

Are you constantly asking for others to repeat what they say? Hearing loss happens incrementally and can go unnoticed for some time. In fact, as we age, we expect to lose some hearing capabilities. But hearing loss can also be a sign of something more serious — an acoustic neuroma.

A vestibular schwannoma, or acoustic neuroma, is a rare, benign brain tumor that grows on the eighth cranial nerve in the brain. This nerve transmits sound and equilibrium (balance) from the inner ear to the brain.

Because the tumor is slow-growing, hearing loss is gradual, making it hard to pinpoint when the neuroma actually begins to interrupt normal hearing. Acoustic neuromas account for only 7.5 percent of brain tumors.

Risk factors for acoustic neuroma

 The risk factors for acoustic neuroma are not well understood. So it’s important to keep close tabs on your hearing and get it checked if you think something is amiss.

One study determined that childhood radiation exposure increases the risk of acoustic neuroma. Another theory suggests that cells designed to coat nerve fibers with insulation kick into overdrive instead of stopping. The result is a wart-like tumor that grows on the nerve.

“A vestibular schwannoma is the second most common tumor inside the head,” said John Oghalai, MD, Tiber Alpert Professor and chair of the USC Tina and Rick Caruso Department of Otolaryngology – Head and Neck Surgery at the Keck School of Medicine of USC. “It occurs in about one in 100,000 people.”

Common symptoms

 The most common symptom that patients experience first is hearing loss on one side. This could be accompanied with ringing in the ear. Other symptoms include dizziness, numbness, problems with balance and tingling on one side of the face.

“While everybody loses hearing gradually as they age, it should occur equally in both ears,” Dr. Oghalai said. “If you notice that you can’t hear as well out of one ear as the other, this needs to be checked. An asymmetry in hearing is concerning and needs evaluation.”

Treatment 0ptions

The size of the tumor, existing level of hearing, age and medical condition of the patient and the symptoms experienced all affect the way acoustic neuroma will be treated. There are three common treatments:

  • Microsurgery – Your doctor will perform surgery in an operating room using state-of-the-art microsurgical approaches and equipment. This surgery is optimal for young, healthy patients who want to preserve their hearing.
  • Radiosurgery – Using radiation, the goal is to halt the growth of the tumor without injuring nerves and tissue around it. This type of treatment is generally use for tumors under 2.5 centimeters in diameter.
  • Watch and Wait – If your tumor is small and you have minimal symptoms, this approach may be recommended. Every six months you will be asked to get an MRI to monitor the tumor’s growth.

The main goal of treatment is to preserve hearing to the level it is at when a diagnosis is first made. But regardless of the treatment chosen, it will not recover hearing to a prior state.

Maintaining facial-nerve function and minimizing the need for future treatment are other goals. Your doctor will determine the treatment that is best for you.

If you are diagnosed with acoustic neuroma, search for a highly specialized treatment center that routinely treats acoustic neuroma.

“Luckily, they are really slow-growing, and so there is rarely ever a rush to do anything,” Dr. Oghalai said. “There is plenty of time to learn about the problem and to make an informed decision of how to manage it. We at Keck Medicine of USC are here to help you make the decision that is right for you and your family.”

If you are experiencing trouble with your hearing, make an appointment with one of the world-renowned specialists at the USC Acoustic Neuroma Center at Keck Medicine at USC. If you are in the Los Angeles area, schedule an appointment by calling (800) USC-CARE (800-872-2273) or by visiting https://acousticneuroma.keckmedicine.org/request-an-appointment/.

By Heidi Tyline King