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An acoustic neuroma is a benign, slow-growing tumour on the nerve between your inner ear and brain. Most cause gradual one-sided hearing loss. CION explains your options clearly — and many small tumours need only monitoring, not surgery.
An acoustic neuroma — more accurately called a vestibular schwannoma — is a benign (non-cancerous) tumour. It grows from the Schwann cells that wrap the nerve connecting your inner ear to your brain. It is not a brain cancer, and it does not spread to other parts of the body.
Most acoustic neuromas grow slowly, and many cause few problems for years. The first sign is usually gradual hearing loss in one ear, often with ringing (tinnitus). Because the tumour sits in a tight space at the base of the brain, a doctor will keep an eye on it — but a diagnosis is rarely the emergency many people fear. This page explains the symptoms, how an MRI confirms the tumour, and the three real treatment paths, written and reviewed by the CION neuro-oncology team. You can also read our wider brain tumour overview for context on benign and malignant tumours.
Vestibular schwannomas usually arise from the balance (vestibular) part of the nerve, not the hearing (acoustic) part — which is why "vestibular schwannoma" is the more accurate name. The American Academy of Otolaryngology and the EANO note that many small tumours grow very slowly or not at all, so observation with repeat MRI ("watch and scan") is a recognised, mainstream first option — not a delay in care.
Symptoms usually come on slowly over months or years, because the tumour grows gradually. They almost always affect one side only. Common signs include:
Most one-sided hearing problems are caused by everyday things — ear wax, infection, or noise damage — and an acoustic neuroma is a rare cause. But because it is a "don't-miss" cause, a one-sided change that is new, persistent, or getting worse deserves a hearing test and, if needed, an MRI. Learn more about one-sided hearing loss and ringing, and when it should be checked.
When to get checked promptly: sudden hearing loss in one ear, or hearing loss with facial weakness, should be assessed quickly. Talk to a CION specialist if this sounds like you.
Acoustic neuromas are uncommon and usually appear in adults aged 30 to 60. In most people there is no known cause. Two factors are recognised:
Is it serious? Because it is benign, an acoustic neuroma is not life-threatening in the way cancer can be, and many never need treatment. What matters is monitoring growth and protecting your hearing, balance, and facial nerve. The earlier a tumour is found, the more options you usually have — which is why a persistent one-sided hearing change is worth checking. For how benign tumours differ from malignant ones, see our brain cancer and tumour hub.
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Whether you've just been told you have a vestibular schwannoma or you're weighing watch-and-scan against treatment, our team will talk you through it — calmly and without pressure.
Diagnosis is usually a two-step process that starts the moment one-sided hearing loss is taken seriously.
The first test is a simple, painless hearing test. It measures how well each ear hears across different pitches. A pattern of one-sided hearing loss — especially affecting higher pitches and speech clarity — is the clue that prompts further imaging.
The definitive test is an MRI scan with gadolinium contrast. It is the gold standard because it shows even very small tumours on the nerve, measures the tumour's exact size and position, and reveals its relationship to the brainstem and facial nerve. If you cannot have an MRI, a CT scan may be used instead. MRI is also how a known tumour is monitored over time. Learn more about MRI for brain tumours and what the scan shows.
Occasionally balance testing is added to understand how much the affected nerve is contributing. At CION, your imaging is read by specialists who characterise the tumour and help decide the right next step — monitoring, radiosurgery, or surgery.
There is rarely a single "right" answer. The best choice depends on the tumour's size and growth, your current hearing, your age, and your own preferences. NCCN and EANO recognise all three approaches below.
For small tumours with mild or stable symptoms, the safest plan is often to do nothing active and simply monitor with repeat MRI scans, usually starting at 6–12 months. Because many acoustic neuromas grow very slowly or not at all, this avoids the risks of treatment unless and until the tumour actually grows. It is a mainstream, recognised option — not a delay in care.
For small to medium tumours, stereotactic radiosurgery delivers highly focused radiation beams to the tumour from many angles at once — with no incision and no general anaesthetic. Despite the name, no cutting is involved. The goal is to stop the tumour growing while protecting hearing and the facial nerve. CION plans and delivers radiation directly as part of coordinated radiosurgery and specialist care.
For larger tumours, or those pressing on the brainstem, surgical removal may be the best option. At CION this is coordinated with our accredited neurosurgical partners, who perform the operation — while our team manages your imaging, any radiation, steroids, symptom control, and the overall plan, so your care stays joined-up.
Acoustic neuroma care touches several specialties, so it helps to know exactly who does what at CION:
This means you are not bounced between disconnected providers. One coordinated team holds your imaging, your decisions, and your follow-up together. For the bigger picture on neuro-oncology at CION, see our brain tumour treatment in Hyderabad page.
For most acoustic neuromas, "radiosurgery" involves no cutting at all. EANO guidance describes stereotactic radiosurgery as a non-invasive way to control small-to-medium vestibular schwannomas while aiming to preserve hearing and facial-nerve function — often as an alternative to open surgery, with no hospital admission for most patients.
An acoustic neuroma is rarely an emergency, which means you usually have time to make a calm, well-informed decision. A second opinion is especially worthwhile if:
At CION, your case goes to a multidisciplinary tumour board, and we offer a free written second opinion after a 45-minute consultation. We walk this journey with you. Book your free consultation or call 18002028726.
Get a free written second opinion from CION's tumour board — particularly valuable before agreeing to surgery, or if watch-and-scan and hearing preservation haven't been explained to you.
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Start Your Story. Book Free Consultation.No. An acoustic neuroma — also called a vestibular schwannoma — is a benign (non-cancerous) tumour. It grows from the Schwann cells that wrap the vestibulocochlear nerve, the nerve connecting the inner ear to the brain. It does not spread to other parts of the body the way cancer does. However, because it sits in a tight space at the base of the brain, a growing tumour can press on nearby nerves and structures. So even though it is benign, it is monitored carefully and treated when it threatens hearing, balance, or other functions.
They are the same tumour — two names for one thing. "Acoustic neuroma" is the older, more familiar term. "Vestibular schwannoma" is the more accurate medical name, because the tumour usually arises from the vestibular (balance) part of the nerve, not the acoustic (hearing) part, and it grows from Schwann cells. You may see either term on your scan report or in your doctor's notes. Both describe a benign tumour on the nerve between the inner ear and the brain.
No. Many small acoustic neuromas are simply monitored with repeat MRI scans ("watch and scan"), because a good number grow very slowly or not at all. Treatment is considered when the tumour grows, when symptoms worsen, or when the tumour is large. The three main options are observation, stereotactic radiosurgery (focused radiation, no incision), and microsurgery. The right choice depends on tumour size, your hearing, your age, and your preferences. At CION we discuss all options openly so the decision fits your situation.
Not necessarily. Many people have some hearing loss on the affected side at diagnosis, often gradual and one-sided, sometimes with ringing (tinnitus). With observation, hearing may stay stable for years in slow-growing tumours. With stereotactic radiosurgery, the goal is to control the tumour while preserving as much useful hearing as possible. Surgery may affect hearing depending on tumour size and location. Your team will explain the realistic outlook for your hearing based on your specific tumour and current hearing test results.
CION delivers the parts of acoustic neuroma care that are oncology-led directly — MRI diagnosis and characterisation, monitoring, stereotactic radiosurgery planning and delivery, steroid and symptom management, and supportive care. When microsurgery (removal of the tumour) is the right choice, it is coordinated with our accredited neurosurgical partners, who perform the operation, while our team manages the imaging, radiation, and overall plan. This means you get one coordinated pathway rather than being sent between disconnected providers.
See a doctor if you have hearing loss in one ear that is new, getting worse, or comes with ringing (tinnitus) or unsteadiness — especially if it does not improve. One-sided hearing loss is most often caused by everyday issues like wax, infection, or noise damage, and an acoustic neuroma is a rare cause. But because it is a "don't-miss" cause, a one-sided change that persists deserves a hearing test and, if needed, an MRI scan. Read more about one-sided hearing loss and acoustic neuroma.
Diagnosis usually starts with a hearing test (audiogram) that shows one-sided hearing loss. The definitive test is an MRI of the brain with contrast, which clearly shows even small tumours on the nerve and measures their size and position. Sometimes balance testing is added. MRI is also used to monitor a known tumour over time. At CION, imaging is read by specialists who characterise the tumour and help plan whether observation, radiosurgery, or surgery is the best next step for you.
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