Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be

talking to you about Acoustic Neuromas. And you can find written notes on this topic at

0.0.com slash acoustic neuroma or in the ear, nose and throat section of the zero definals surgery book.

So let's get straight into it.

Acoustic neuromas are benign tumours of the schwan cells surrounding the auditory nerve

or the vestibular cochlear nerve that innovates the inner ear.

They're also called vestibular schwanomas as they originate from the swan cells.

Swan cells are found in the peripheral nervous system and they provide the myelin sheath

that surrounds neurons.

Acoustic neuromas occur at the cerebellopontyne angle and are sometimes referred to as cerebellopontyne angle tumours.

Acoustic neuromas are usually unilateral. Bilateral acoustic neuromas are associated with neurofibromatosis type 2.

A tom tip for you, bilateral acoustic neuromas almost certainly indicate neurofibromatosis type 2. Atomtip for you, bilateral acoustic neuromas almost certainly indicate neurofibromatosis

type 2. This is a popular association in exams, so it's worth remembering. Let's talk about the

presentation. A typical patient is aged 40 to 60 years presenting with a gradual onset of unilateral sensory neural hearing loss,

which is often the first symptom, unilateral tinnitus, which is a ringing or an extra sound

in the ear, dizziness or imbalance, and a sensation of fullness in the ear. They can also be associated with a facial nerve palsy

if the tumor grows large enough to compress the facial nerve.

Next let's talk about investigations.

Audiometry is used to assess hearing loss,

and this will show a sensory neural pattern of hearing loss.

Brain imaging such as an MRI scan or a CT scan can be used to establish a diagnosis and the features of the tumour.

MRI scans provide more detail than CT scans.

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