Early symptoms of auditory neuroma include tinnitus, vertigo, and hearing loss. As the tumor increases in size, it may cause unstable walking, facial pain, facial palsy, and other manifestations of cerebellar and peripheral cranial nerve compression, and then cause serious and life-threatening symptoms such as increased intracranial pressure. The tumor will push or compress the auditory nerve, vestibular nerve and the accompanying internal auditory artery, which in turn will affect the blood supply to the inner ear and degenerate as a sensory structure, manifesting as unilateral slowly progressive (occasionally sudden) deafness, high pitched tinnitus, dizziness and unsteadiness. If the middle nerve and facial nerve are pushed, there will be pain in the ear, change of salivary gland and lacrimal gland secretion, prelingual taste sensation, abnormal facial muscle spasm, muscle weakness or paralysis. If the tumor contacts and compresses the brainstem and cerebellum, it may cause spontaneous nystagmus and ataxia. If the tumor is too large, it may cause obstruction of peripheral venous return and cerebrospinal fluid circulation, which may increase intracranial pressure and lead to headache, nausea and vomiting. What are the symptoms of auditory neuroma? Early symptoms: Tinnitus: It is one-sided, with varying pitch and progressive increase, mostly starts at the same time with hearing loss, but it may be the only symptom in early stage. Hearing loss: Progressive deafness on one side, often manifested in the early stage as hearing the sound without knowing its meaning when talking to someone, gradually developing into total deafness. Vertigo: A few manifest as transient rotational vertigo with pressure in the ear, nausea, vomiting, such as symptoms of fluid accumulation in the membranous vagus, but most manifest as a feeling of instability; due to the slow development of the tumor, the vestibule gradually compensates and the vertigo may disappear. Pain deep inside the affected ear or mastoid area and numbness in the posterior wall of external auditory canal. Symptoms when the tumor has invaded or originated in the posterior cranial fossa: involvement of sensory branch of trigeminal nerve; ipsilateral facial numbness. Ipsilateral peripheral facial paralysis may occur. In advanced stage, the tumor compresses the cerebellum, then vocal slurring and motor disorders appear. Headache: initially located in the occipital and parietal regions, and in advanced stage, full headache due to increased intracranial pressure; it may also be accompanied by visual impairment and involvement of cerebral conduction tract. How is an auditory neuroma treated? However, in some patients, despite complete surgical excision, the tumor may be too close to the nerve and lead to complications, such as incomplete eyelid closure, exposure keratitis, various degrees of dry eyes, and crookedness of the mouth and eyes. Some patients put the preservation of the facial nerve first and do not agree to a total surgical excision, thus not achieving the best treatment outcome. It is recommended that each patient be treated according to his or her specific situation, and that a complete excision of the mass and preservation of facial and auditory nerve function be achieved. As for the recurrence of auditory neuroma, very few recurrences have been found in patients who have undergone total resection, including total resection of the mass in the internal auditory canal. Patients who do not have complete excision, however, are at risk for recurrence. Reminder: Middle-aged people with tinnitus and hearing loss should never ignore these seemingly non-serious symptoms, which may well be precursors of auditory neuroma. If the cause of tinnitus cannot be detected in ENT department and the treatment is not effective, further examination should be done as early as possible. If early detection and early diagnosis can be made, the treatment effect of auditory neuroma will be greatly improved, and the preservation rate of the facial and auditory nerves will be increased.