Article reprinted from: Song of the Deaf
“Crooked? What did you say? Loud, I can’t hear you clearly.”
Strange, at the age of 30, why are you deaf?
Be slow and slow, but don’t be careless. Deafness and tinnitus at a young age, accompanied by symptoms of dizziness and nausea, beware of an acoustic schwannoma !
What is an acoustic schwannoma, which means a tumor in the ear?
Ears and eyes are so small, how can tumors grow?
In fact, it is not in the external auditory canal, but near the inner ear hole in the skull.
Acoustic schwannoma is a common intracranial tumor, which is located in the auditory nerve sheath and originates from Schwann cells of the vestibular nerve, and rarely occurs in the cochlear nerve.
Acoustic schwannoma is more common in adults, the age of onset is mostly 30 to 50 years old, and patients under 20 years old are relatively rare. The incidence of left and right ears is similar, and bilateral ears are occasionally affected at the same time.
When an acoustic schwannoma occurs, patients usually have some of the following symptoms:
In the early stage of auditory schwannomas, due to the relatively small size of the tumor, the auditory nerve is mainly affected, and one side of the tinnitus and hearing loss will occur.
Patients usually choose otolaryngology for treatment. After excluding diseases such as otitis media, they must pass imaging examinations to determine whether they have acoustic schwannomas.
As the tumor grows and expands, it can compress surrounding nerves, most commonly the facial and trigeminal nerves. Patients will experience facial muscle twitching, decreased tear secretion, and even mild facial paralysis.
Compression of the trigeminal nerve causes facial numbness, decreased facial pain and touch, and weakness of the masticatory muscles when eating. When the disease progresses to this stage, patients usually seek medical attention proactively.
In the advanced stage of acoustic schwannomas, the tumor volume continues to increase, compressing the brainstem, cerebellum and cranial nerves, causing gait instability, dysphonia, hoarseness, eating and drinking, etc., resulting in vision loss and optic atrophy.
The growth rate of auditory schwannomas varies from person to person, and early deafness symptoms are easily overlooked, often realizing hearing loss in one ear while answering the phone in alternate ears.
Therefore, if you have deafness and tinnitus, you must go to the hospital in time. If necessary, follow the doctor’s advice and use an enhanced MRI of the internal auditory canal to diagnose whether you have an acoustic schwannoma.
At present, authoritative certification at home and abroad, the most effective method for the treatment of acoustic schwannoma is surgical resection.
The primary goal of acoustic schwannoma surgery is to safely remove the tumor completely, with as much integrity as possible of the facial nerve and no serious neurological sequelae.
Acoustic schwannomas are located in the brain, surrounded by many important nerves and blood vessels.
In the early stage, when the tumor volume is small, surgical resection is more convenient and flexible, resulting in less irreversible damage, lower surgical risk, and less sequelae.
If the tumor has progressed to the middle and advanced stage, it is difficult to completely remove it by surgery, and it is easy to accidentally injure the surrounding tissues. No matter how skilled the doctor is, the sequelae of facial nerve injury will inevitably be left, such as facial muscle twitching or paralysis, grinning and slurred speech.
Therefore, acoustic schwannomas need early detection and early treatment.
If the patient has developed deafness, but has not affected other nerves, and has no other accompanying symptoms, he can temporarily observe for a period of time, follow up regularly, do MRI examinations, and monitor the growth rate of the tumor.
Once the signs of surgery are found, surgical excision is recommended as soon as possible. Acoustic schwannoma is a benign tumor. Early excision can not only cure and preserve the patient’s unilateral hearing, but also protect the peripheral cranial nerves and blood vessels, which is beneficial to the functional protection of nerves and brainstem.
Expert introduction
Chen Zhengnong
Department of Otolaryngology, Shanghai Sixth People’s Hospital
Doctor of Medicine, Chief Physician, Doctoral Supervisor, Deputy Director of the Department
He is currently the deputy director of the Youth Committee of the Otolaryngology and Head and Neck Surgery Branch of the Chinese Medical Association, the deputy director of the Youth Committee of the Otolaryngology and Head Surgery Branch of the China Medical Association, and the deputy director of the Youth Committee of the Shanghai Medical Association Otolaryngology Society. He is also the editorial board member of “Chinese Journal of Otology” and the corresponding editorial board of “Chinese Journal of Otolaryngology and Head and Neck Surgery”.
He has long been engaged in clinical work and basic research on lateral skull base and ear diseases. He is proficient in various surgeries related to otology, otology neurosurgery and skull base surgery. And lateral skull base tumor diseases such as tympanic spherical tumor. Relevant achievements have won the first prize of Shanghai Science and Technology Progress Award and the second prize of Science and Technology Progress Award.
In 2013, he was awarded the title of Outstanding Young Physician of the Otolaryngology Branch of the Chinese Medical Doctor Association; in 2015, he was selected into the Shanghai Pujiang Talent Program. Undertook 4 projects of the National Natural Science Foundation of China. Published 65 SCI papers, including 37 first and corresponding authors. The main translation of 2 medical monographs (“Acoustic Neuroma Microsurgery Atlas”, “Skull Base Paraganglioma Microsurgery”).