Tumor size versus hearing loss

[lholl36233]

Hi,

I have to ask those who might have missed it on my other post.  The doctor said they have seen people with small tumors lose hearing but people with large tumors retain hearing.  You would think a larger tumor pressing on the hearing nerve would cause the hearing loss?  My hearing has gotten worse but my tumor hasn't changed.

Ever heard of this?

Thanks.

[Jim Scott]

Laura ~

Yes, I have heard of this, that is, a small tumor damaging hearing when a larger tumor doesn't - or does less damage.  You can attribute much of this paradox to the exact placement of the tumor and how long it has compromised the nerve (which is delicate).  As with real estate, location is critical.  Others may offer more detailed, precise information but the fact remains that with ANs, size doesn't necessary dictate the extent of nerve damage inflicted on the nerve by the tumor.

Jim

[CHD63]

To my knowledge, the place of the AN, not its size, determines what symptoms one has.  Therefore it seems we can assume that if someone's small AN is pressing more on the auditory nerve and another person's large one is not as close to the part of the nerve affecting hearing, this would explain that.  Since ANs (vestibular schwannomas) begin on the vestibular portion of the nerve, it also would explain why everyone has balance involvement.  Although many times the growth is so slow that the brain adjusts to the balance (vestibular) signals from the other good side without the patient ever experiencing noticeable problems.

Also ANs do not grow equally in all directions since they begin in the auditory canal.

It is a little puzzling why your hearing is getting worse but the tumor has not changed.  Perhaps it is growing so slowly that the MRI is not revealing a measurable change, but it is enough to be pressing more on the auditory nerve.  Many people on this forum have found that on resections the tumor was actually much larger than measured on the MRI.

Do not ignore the continued hearing loss.  And make certain your doctor is aware of progressing symptoms.

Clarice

[lholl36233]

Thank you Clarice.  Read all about me here.  I don't ignore anthing.

http://anausa.org/forum/index.php?topic=10361.msg119492#new

[CHD63]

Laura .....

Sorry I did not do my homework and look back on your posts.  I hope you have some answers on your September appointment.  It sounds like you are in good hands.

My thoughts and prayers as you go through these next steps.

Clarice

[mk]

Hi Laura,

there are many of us on the forum with larger tumors (in the 3 cm range) that had none or minimal hearing loss upon diagnosis. It seems that the ANs that are located in the IAC (internal auditory canal) actually cause more symptoms than those located in the CPA (cerebellopontine angle). so it is definitely a matter of location.
Hearing loss can happen even if the tumor doesn't grow. It is due to tumor related edema, i.e. the surrounding structures, may be inflammed, or the blood supply to the nerve reduced because of the presence of the tumor, thus causing hearing loss (sometimes sudden). If the hearing loss is sudden, very often a short course of steroids reverses the loss.

Hope this helps!

Marianna

[leapyrtwins]

The interesting thing about ANs is that small ones can cause big symptoms and big ones can cause small symptoms.  There doesn't seem to be a lot of rhyme or reason involved other than location - as others have said.

It's also true that not everyone experiences the same symptoms that ultimately lead them to their diagnosis, which is why lots of patients go undiagnosed or are misdiagnosed for years. 

We are all unique to some extent - and our AN journeys seem to follow this uniqueness.

Jan

[another NY postie]

I don't know who, or maybe many, have said this .... "small but mighty"
I have a small 5 mm
Hearing loss that continues.....
Mine is as far as you can get in the IAC and right up against the cochlea
DRs have explained that this makes it more challenging to preserved hearing - my ABR 5th wave was 5.6 (and the cut off I had seen in medical abstracts was 6.8 as an indicator for hearing preservation)
So, I would say definitely LOCATION plays a huge role in my little booger.
That is probably why I caught it so early, because of my hearing symptoms
I also have some facial pain issues around the ear that may be facial nerve related or could be more clutching my jaw in frustration!
DR also said where mine is is the narrowest part of IAC, so that makes sense that I would have symptoms though small...