This page explains what a vestibular schwannoma (VS) is and what it might mean for you. Your doctors and nurses can tell you more and answer your questions. At the end, there is information about groups that can help.
What is a VS?
A vestibular schwannoma, also called an acoustic neuroma, is a non-cancerous tumour. It grows on the balance nerve that
connects the inner ear to the brain. This nerve sits very close to the hearing nerve and to the facial nerve, which helps you move your face.
Because the tumour is benign, it does not spread to other parts of your brain or body.
What causes a VS?
The tumour starts in Schwann cells, which are cells that cover nerves and help them send messages. Most of the time, doctors do not know why the tumour appears. A very small number of people with a rare condition called NF2 can get tumours on both sides of the head.
Symptoms
A VS usually grows very slowly, so symptoms may take months or years to appear. Some people do not notice any symptoms at first.
As the tumour grows, it may press on nerves nearby. This can cause hearing loss, ringing in the ear, dizziness, or balance problems. If it grows more, it may cause numbness in the face, weakness in the face, pain around the ear, or trouble walking steadily.
Very large tumours can block the normal flow of fluid around the brain and cause something called hydrocephalus. This can lead to strong headaches, sickness, vision problems, nausea, memory troubles, wobbliness, or feeling extremely sleepy.
If you suddenly lose hearing in one ear or suddenly notice weakness on one side of your face, you should get urgent medical help from your doctor or go to an Emergency Department. Steroid medicine may help if it is given quickly.
Diagnosis and tests
A VS is sometimes first noticed after an unusual hearing test result. You may have more hearing tests to check how well you hear sounds and speech. Sometimes, a VS is found on a scan performed for a different reason altogether.
Most VS tumours are found using an MRI scan. This scan is safe and does not hurt. If someone finds small spaces uncomfortable, they may have be offered a mild sedative.
Some people cannot have an MRI because of metal in their body, such as a pacemaker. In that case, a CT scan can be used to make the diagnosis.
The care team (MDT)
Your care is planned by a group of specialists called the MDT (Multi-Disciplinary Team). This team includes many experts, such as brain surgeons, ENT surgeons, radiotherapy doctors, scan specialists, specialist nurses, and a coordinator. They look at your symptoms, age, your general health, the size of the tumour, and how fast it is growing. Your consultant will talk to you about what the team suggests.
Treatment options
Watch and wait
If the tumour is small/medium and not causing problems, you may not need treatment straight away. Instead, you may have regular MRI scans to check whether it is growing.
Radiotherapy
If the VS is growing, or a reasonable size when it is discovered, the MDT may suggest radiotherapy. Radiotherapy uses powerful energy beams to damage the tumour cells, so they stop growing. A common method is called Gamma Knife, which many people have in one day, although sometimes treatment takes place over several days or weeks.
Radiotherapy for VS is done at the Bristol Oncology Centre. If the MDT suggests radiotherapy, you will be seen by the Oncology team at the Bristol Haematology and Oncology Centre. The Oncology team will discuss the pros and cons of radiotherapy in more detail.
Surgery
Surgery may be needed depending on the size and position of the tumour, and the symptoms you have. This is a significant operation and needs to be planned carefully.
The tumour can be removed through the bone or skull behind the ear. Before surgery, you will meet the surgeon to talk about your symptoms, why surgery is recommended, what will happen during the operation, how long recovery might take, and any risks.
Surgery for VS is mostly non-urgent, however large tumours causing hydrocephalus require more urgent surgery. You will have time to think about your decision. The aim of the surgery is to remove as much of the tumour as possible while protecting the nerves nearby, especially the facial nerve. Sometimes a thin layer of the tumour is left behind to protect the nerve, and this area is checked later with MRI scans.
Before your surgery, you will go to a clinic where you will have an examination, blood tests, an ECG, and possibly other tests. You can ask more questions there. On the day of the surgery, you will see your surgeon and the anaesthetist again.
The operation usually takes between 8 and 12 hours. After surgery, you will spend a few days in a high-dependency unit before moving to a normal ward. Most people stay in hospital for about a week to 10 days. Feeling dizzy, sick, or unsteady is common for a while. A physiotherapist can help you learn exercises to improve your balance.
Most people lose hearing in the operated ear, and this usually cannot be fixed. A hearing therapist or audiologist can help with advice and equipment if needed. Weakness in the facial muscles may occur after large tumours are removed. This can make it hard to blink or close one eye, which may become dry. You might need eye drops, gels, or eye protection at night. Physiotherapists can show exercises to help the facial muscles and may arrange more therapy if needed.
In some rare cases, facial weakness can be more severe or last longer. Speech or swallowing can also be affected, and a speech and language therapist can help. Sometimes a feeding tube is needed for a short time.
Serious problems such as infection, meningitis, leaking brain fluid, brain damage, or hydrocephalus are rare. The risk of serious neurological or life-threatening complications are very rare. You should get urgent medical help if you notice clear fluid coming from your nose or ear, a fever, a stiff neck, headaches that get worse, vision problems, new facial weakness, or a wound that looks red or swollen.
Hearing loss
Hearing loss in one ear is the most common symptom of VS.
The other ear is not affected. This can make it harder to know where sound is coming from or to hear when there is background noise. Hearing loss caused by VS is usually permanent. It may continue to worsen in the future, even if the VS is not growing. An audiologist may suggest a hearing aid, a CROS device, or a bone-anchored hearing aid.
Tinnitus
Tinnitus means hearing a sound, such as ringing or buzzing, when nothing outside your body is making the noise. It is very common and can be worse in the ear affected by the VS. Tinnitus UK is a national charity that offers support and advice. They have an excellent website with lots of information (tinnitus.org.uk). Many audiology teams can also help with tinnitus.
Dizziness
A VS can affect the balance system in the ear, which may make you feel unsteady, especially when turning quickly or doing complicated movements. Some people have short spinning feelings called vertigo. Staying active is usually the best way to get better because it helps your body learn to balance again. Physiotherapists can teach exercises that help your balance recover. These can feel difficult at first, but most people improve over time. If dizziness suddenly becomes very bad, you should see a doctor.
Sudden changes
Sometimes symptoms can suddenly get worse. If you suddenly lose hearing in one ear within three days or notice new facial weakness, you should see your GP or go to the Emergency Department on the same day. Steroid medicine may help if it is given early. Very large tumours can cause hydrocephalus, which is serious. Strong headaches, sickness, vision problems, memory trouble, or feeling very sleepy should be checked urgently.
Driving
You can drive again once you have fully recovered from surgery. You do not need to tell the DVLA, but you should tell your insurance company. You can ask your GP to help check that you are ready to drive. You may need to inform the DVLA if you have sudden, disabling, or recurrent dizziness.
Follow-up and recovery
Follow-up
Two to three months after surgery, you will return to the Skull Base Clinic for a check-up. You will also have a phone call with a Brain Tumour Support Worker about four weeks after going home. Many people have an MRI scan around three months after surgery, and you may need more scans if a small piece of the tumour was left behind. Long term support for hearing loss, tinnitus and balance problems can be provided by your local audiology team.
Recovery
Everyone recovers at a different speed. It is normal to feel very tired for several weeks after surgery. It helps to rest and slowly increase your activity over time. Many people need between three and six months off work to recover fully. If you have questions while you recover, the specialist nurse team can support you.
Further support
British Acoustic Neuroma Association
Website: BANA UK | British Acoustic Neuroma Association
Phone: 01246550011
Email: admin@bana-uk.com
Brain Tumour Support
Website: Home - Brain Tumour Support
General enquiries: 01454 414 355
Support Services line: 01454 422 701
Support email: support@braintumoursupport.co.uk
Information email: info@braintumoursupport.co.uk
Facial Palsy UK
Website: Facial Palsy UK - Supporting people affected by facial paralysis
Enquiries: 0300 030 9333
Email: info@facialpalsy.org.uk
Hearing Link
Website: Hearing Link Services | Hearing Dogs for Deaf People
Phone: 01844 348111
Email: enquiries@hearinglink.org
Action for Hearing Loss
Website: RNID - National hearing loss charity
Phone: 0808 808 0123
SMS: 07360 268 988
Email: contact@rnid.org.uk
Brain Trust
Website: Home - Brainstrust, brain tumour charity
Phone: 01983 292 405
Email: hello@brainstrust.org.uk
Brain Tumour Charity
Website: The Brain Tumour Charity | Research - Support - Campaigning
Phone: 0808 800 0004
Contact: Contact us | The Brain Tumour Charity
Tinnitus UK
Website: Home - Tinnitus UK
Phone: 0800 0180 527
Email: helpline@tinnitus.org.uk
Date published: 30 June 2026 Review due: 30 June 2029 PI number: BFT003103