Expert: Dina Q Goldin, Ph.D. - 12/7/2008

Question
I had hearing loss in my left ear & noise.Consulted with ENT specialist.He advised Audiological tests & MRI.
The audiometry test say 'severe sensorineural hearing loss of left ear.The MRI report say"There is mild expansion and enhancement of the left 7th/8th nerve complex essentially confined within the canal likely to represent a small acoustic neuroma.The lesion measure around 17x3 mm in widest dimension."
I do not feel any pain and only some hearing loss of left ear and tinnitis some times tolerable.I want the opinion of some of experienced yahoo reader who can advise me what to do in this situation?


Answer
Your symptoms, and the MRI results are consistent with a small to medium-size Acoustic Neuroma. ANs do not cause any pain when they are not large, only noise and hearing loss in one ear.

It sounds like the MRI was done without gadolinium, which is a contrasting agent that must be used to show the AN. Without it, they can see the expansion of the surrounding tissues caused by the pressure of the AN, but not the tumor itself (which is what is happening in your case).   

I am not sure it makes sense to redo the MRI properly, to get the exact shape/size/position of the tumor.  If you choose to have radiosurgery, they would have to redo it anyway, so as to plan the treatment properly.  And if you choose surgery, the exact shape does not matter, since the whole area will be opened up anyway.  Just make sure that you consult with BOTH types of specialists and understand your prognosis with each before making your decision; also, make sure to find the most experienced team possible, since that makes all the difference as far as the potential risks from treatment (especially surgery).

If you do not mind the symptoms, you can also choose to wait and watch rather than be treated; this option is being chosen by more and more AN patients since ANs are slow-growing and benign. In this case, you will need regular MRIs to monitor the growth of the tumor (let's hope there isn't any), in which case please make sure that any subsequent MRIs are performed properly.