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Approximately 50% of patients with small tumors may experience reduced speech discrimination while up to 70% of people with larger acoustic neuromas may complain of compromised accuracy of speech discrimination.

Tinnitus

Tinnitus - a ringing or roaring in the ears - is an indication of cochlear nerve dysfunction and is a common symptom of acoustic neuromas. In the majority of cases, the tinnitus is high pitched and only occurs in the ear affected by the tumor (unilateral). A small number of patients, however, may experience bilateral tinnitus. It is generally regarded as an early symptom of acoustic neuroma. Tinnitus rarely appears without accompanying hearing loss though hearing loss may be experienced without tinnitus. Investigators from the Mayo Clinic reported that that 70% of patients with acoustic neuromas experienced tinnitus. To read more about this study, click on the following link: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&listuids=7301081&queryhl=4&itool=pubmed_docsum

Vertigo

True vertigo, a disabling sensation in which an individual feels that his/her surroundings are in constant motion, occurs in about 19% of people with acoustic neuromas. It is more commonly experienced in the early growth stages of the tumor when it is small.

Vestibular (Balance) Dysfunction

As the tumor grows and places pressure on the vestibulocochlear nerve, patients may also experience balance problems or unsteadiness on their feet. In many cases, however, this symptom goes undetected because the vestibular system is very good at compensating for the loss of equilibrium which may further delay diagnosis. Approximately 50% of patients with large tumors suffer from problems of vestibular dysfunction. These problems appear more frequently with larger tumors due to increased compression on the vestibular nerve.

Cerebellar dysfunction is characterized by intention tremor and gait ataxia (unsteadiness while walking). True cerebellar dysfunction is less common in people with acoustic neuromas and is often limited to patients with large tumors. When this occurs, patients tend to fall towards the side where the tumor is located.

Facial Nerve and Trigeminal Nerve Dysfunction

Other cranial nerves may also be affected by tumor growth. If the 7th cranial nerve, the facial nerve, is compressed by the tumor, a person may experience facial weakness on the affected side, slurred speech, difficulty closing the eyelid, and decreased or absent corneal reflex. It is estimated that approximately 25% of patients experience facial numbness while facial weakness is relatively uncommon.

Compression of the 5th cranial nerve, the trigeminal nerve, which is responsible for facial sensation, may result in facial paresthesia (a "pins and needles" tingling) or anesthesia (loss of feeling and sensation) especially in the cheeks as well as difficulty chewing. Symptoms of facial numbness and tingling are often indicative of a larger tumor pressing against the trigeminal nerve. The numbness and tingling can occur intermittently or be constant. Symptoms related to the trigeminal nerve correlate with the size of the acoustic neuroma. If the tumor is less than 1 cm. in size, there is typically no pain whereas if it is larger than 3 cm, up to 48% of patients complain of symptoms associated with acoustic neuromas. Some studies indicate that, on the average, approximately 10% of patients present to the clinician with trigeminal nerve involvement at the time of diagnosis.

Headache