If you’ve recently been told you may have an acoustic neuroma—or you’re experiencing unexplained hearing loss, ringing in your ears, or persistent balance issues—the road ahead can feel uncertain. At Princeton Brain, Spine & Orthopedics, we help patients across Mercer County, New Jersey, and Eastern Pennsylvania understand this rare condition, weigh their treatment options, and move forward with a clear, personalized plan built around their goals.
For nearly two decades, our fellowship-trained neurosurgeons have specialized in the diagnosis and treatment of complex skull-base tumors, including acoustic neuromas (vestibular schwannomas). Our award-winning team partners with top-rated hospitals and collaborates closely with audiologists, radiologists, and rehabilitation specialists to deliver advanced, evidence-based care—from precise MRI-based diagnosis to microsurgical resection and Gamma Knife radiosurgery. Patients throughout NJ and Eastern PA trust PBSO for our depth of surgical experience, transparent communication, and patient-first approach at every stage of treatment.
Causes, Diagnosis & Treatment
An acoustic neuroma is a non-cancerous, slow-growing tumor that grows at a rate of approximately 1 to 10 mm per year. Acoustic neuromas arise from the eighth cranial nerve, which is associated with balance and hearing. Since these tumors originate from the “Schwann cells” wrapping around the nerve, an acoustic neuroma is more accurately classified as a vestibular schwannoma.
Acoustic neuromas are found in a part of the brain called the cerebellopontine angle (CPA), which lies close to the brainstem. The brainstem regulates vital systems like breathing, heart rate, and blood pressure.
Incidence & Symptoms of Acoustic Neuroma
Acoustic neuromas account for six to eight percent of all intracranial tumors. One in every 100,000 people is affected, and females are twice as likely to be affected. Ninety-five percent of the time, the tumor occurs on only one side (right or left). In rare cases, when the tumor is associated with a genetic disorder called neurofibromatosis (NF) type 2, the neuroma occurs on both sides.
When discovered, an acoustic neuroma is usually greater than two centimeters in diameter. The three most common symptoms are:
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Hearing loss. Slow and gradual, with reported difficulty hearing high-frequency sounds and telephone conversations. About 10 percent of patients have sudden hearing loss, which researchers believe is due to nerve infarction or obstruction of an artery supplying the inner ear.
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Ringing in the ears. Usually high-pitched.
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Balance changes. May include loss of balance and dizziness.
Additional symptoms may occur if the neuroma presses on nearby nerves, including facial numbness or weakness, ear pain, and taste changes. When tumors are larger than two centimeters, they may put pressure on the brainstem—leading to headache, nausea and vomiting, double vision, and, in rare cases, coma or death.
Acoustic Neuroma Diagnosis
An MRI is the best imaging study for acoustic neuroma. The MRI will reveal the tumor’s size and location, which is critical information for the neurosurgeon. All patients should also have a formal hearing test. Your surgeon may also recommend the following tests to differentiate a neuroma from other causes of vertigo and dizziness:
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Head CT
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Caloric stimulation (test for vertigo)
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Electronystagmography (test of equilibrium & balance)
Treatment for Acoustic Neuroma
Considering the patient’s age, medical condition, and hearing quality—as well as the tumor’s size and location—the neurosurgeon will recommend one of three treatment options: observation, radiosurgery, or traditional surgery.
Observation
When your neuroma does not warrant surgery, your PBSO neurosurgeon may choose active surveillance. This process includes serial MRI scans and periodic exams to address changing symptoms. If a tumor grows faster than two millimeters per year, more aggressive treatment may be recommended.
Radiosurgery
Stereotactic radiosurgery (Gamma Knife surgery) is a form of focused radiation delivered directly to the tumor. Radiosurgery is considered for small to medium-sized tumors that are not compressing the brainstem. The goal of radiosurgery is control, not tumor removal. Gamma Knife procedures help patients avoid potential surgical complications while effectively reducing the size of the tumor or slowing its growth.
Surgery
The most common treatment for patients with symptoms is surgical tumor resection (removal). The surgical approach depends on the size of the tumor and the quality of the patient’s hearing, since surgery may cause further hearing loss.
Most experts agree that early intervention is best for young patients. The goal of surgery is long-term tumor control, and complete tumor removal results in a less than one-percent recurrence rate. Partial resection may require a future operation.
Risks & Recovery
The most common surgical complication is a cerebrospinal fluid leak. If this occurs, the neurosurgeon will treat the problem accordingly. Other surgical risks include injury to other nerves, such as the facial nerve that controls face muscles. Typically, one in five patients will have noticeable facial weakness.
Brain surgery results in complete removal of an acoustic neuroma in over 95 percent of cases. In patients with relatively small tumors, about 95 percent will have no permanent facial paralysis following surgery. However, roughly two-thirds of patients with large tumors will have some permanent facial weakness after surgery.
Hearing preservation depends, in part, on the size of the neuroma when it is discovered. If a tumor is removed when it is small, about half of patients retain useful hearing in the affected ear. Hearing lost before surgery will not be regained, and larger tumors often result in total hearing loss on the affected side. Your neurosurgeon will discuss probable outcomes and recovery processes in depth during your pre- and post-operative visits.
Why Choose Princeton Brain, Spine & Orthopedics for Acoustic Neuroma Care
Patients across New Jersey and Eastern Pennsylvania choose PBSO because our award-winning neurosurgical team pairs world-class expertise with a deeply personal, relationship-driven approach refined over nearly 20 years of practice. Each member of our team is board-certified and fellowship-trained, with extensive experience treating acoustic neuromas of every size and complexity. We partner with the region’s leading hospitals, employ the most advanced imaging and surgical technologies available, and collaborate with hearing specialists, radiologists, and rehabilitation experts to support you from initial diagnosis through long-term follow-up. Above all, we listen—taking the time to explain your options clearly, answer every question, and craft a treatment plan tailored to your goals, your health, and your life.
Contact Our NJ & PA Acoustic Neuroma Specialists
If you or a loved one is facing a possible acoustic neuroma diagnosis, the team at Princeton Brain, Spine & Orthopedics is here to help you understand your options and chart a confident path forward. To schedule a consultation at one of our conveniently located New Jersey or Pennsylvania campuses, call PBSO today at (888) 741-7272 or contact us online. Expert, compassionate care is just one phone call away.
