Vestibular Rehabilitation

Vestibular Rehabilitation

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Acoustic Neuroma

What is acoustic neuroma?

Acoustic neuroma, also referred to as vestibular schwannoma, is a noncancerous tumor that may develop from an overproduction of Schwann cells that press on the hearing and balance nerves in the inner ear. Schwann cells are cells that normally wrap around and support nerve fibers. If the tumor becomes large, it can press on the facial nerve or brain structure.

What are the symptoms of acoustic neuroma?

The following are the most common symptoms of acoustic neuroma. However, each individual may experience symptoms differently.

When a neuroma develops, it may cause any or all of the following:

  • Hearing loss

  • Feeling of fullness in the ear

  • Tinnitus. A ringing in the ear.

  • Dizziness

  • Balance problems

  • Facial numbness and tingling with possible, though rare, paralysis of a facial nerve

  • Headaches, clumsy gait, and mental confusion may be life-threatening conditions and require immediate treatment  

The symptoms of acoustic neuroma may resemble other conditions or medical problems. Always consult your health care provider for a diagnosis.

What are the different types of acoustic neuromas?

There are two types of acoustic neuromas:

  • Unilateral acoustic neuromas. This type affects only one ear. This tumor may develop at any age, but most often occurs between the ages of 30 and 60. Acoustic neuroma may be the result of gene damage caused by environmental factors, although no environmental factor has been scientifically proved to cause acoustic neuromas.

  • Bilateral acoustic neuromas. This type affects both ears and is hereditary, caused by a genetic disorder called neurofibromatosis-2.

How are acoustic neuromas diagnosed?

Because symptoms of acoustic neuromas resemble other middle and inner ear conditions, they may be difficult to diagnose. Preliminary diagnostic procedures include an ear examination and a hearing test. Computerized tomography (CT scan) and magnetic resonance imaging scans (MRI) help to determine the location and size of the tumor.

Early diagnosis offers the best opportunity for successful treatment.

Treatment for acoustic neuroma

Specific treatment for acoustic neuroma will be determined by your health care provider based on:

  • Your age, overall health, and medical history

  • Extent of the disease

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Treatment may include observation, surgery, or radiation. Surgery for larger tumors is complicated by the probable damage to hearing, balance, and facial nerves. Another treatment option is radiosurgery, often called the "gamma knife," using carefully focused radiation to reduce the size or limit the growth of the tumor.

Vestibular Rehabilitation is designed to assist individuals with vertigo, dizziness, imbalance, or sensitivity of movement. The vestibular system, or inner ear, plays an integral role in the control of posture and balance. Deficits in the vestibular system may result in loss of balance, decreased independence, inability to perform everyday activities, and increased risk of falls.

Common conditions treated:
  • Benign paroxysmal positional vertigo (BPPV)
  • Vestibular neuritis/Labrynthitis
  • Meniere’s disease
  • Ototoxity
  • Head trauma
  • Post acoustic neuroma resection
  • Vestibulopathy
  • Central vertigo
Services Provided

Vestibular rehabilitation consists of customized activities and exercises to promote adaptation or compensation to a change, deficit, or loss in the vestibular system. Canalith repositioning, or the Epley Maneuver, is also indicated in specific cases. Components of the vestibular evaluation include:
  • Complete history regarding symptoms
  • Oculomotor exam (eye movements)
  • Balance assessment
  • Muscle strength, range of motion, coordination, sensation
  • Gait assessment
  • Motion sensitivity testing
How to Get Started

If you think vestibular rehabilitation can assist you, ask your physician for a referral. Then call 540-536-5113 to make an appointment. Vestibular rehabilitation is covered under Medicare, and many insurance companies will reimburse the cost of this service.

Click here to read an article about vestibular rehabilitation from our Valley Healthlink magazine.