Bilateral Acoustic Neuroma Symptoms and Treatments

Most patients who are diagnosed with an acoustic neuroma only have a single tumor that affects just one side. However, it is possible to develop tumors on both sides, which is called bilateral acoustic neuroma. These cases are uncommon and are typically linked to a rare genetic disease, which will be discussed in a little more detail further on.

Because bilateral acoustic neuroma is somewhat rare, the following information is designed to give you a concise overview of your condition and symptoms, as well as treatment options available in northern NJ. By having a better understanding of your condition, you can become more comfortable with your treatment plan, wherever you are in the process.

More About Your Bilateral Acoustic Neuroma

An acoustic neuroma is a type of tumor that develops from the cells covering the vestibulocochlear nerve, or the 8th cranial nerve. This is the nerve responsible for hearing and balance. Cranial nerves are paired, which means you have one each on your right and left side. Typically, an acoustic neuroma will only grow on one of the two nerves. When tumors develop on both sides, it is called bilateral acoustic neuroma.

Most patients who are diagnosed with bilateral acoustic neuroma also have another condition called Neurofibromatosis Type 2 (NF2). NF2 is a genetic condition involving a loss-of-function mutation of a gene on chromosome 22. In about 50% of cases, the condition appears to be inherited from an affected parent, although the other 50% are spontaneous with no other parents or siblings having the condition. Patients with NF2 often develop bilateral acoustic neuromas, as well as other tumors of the brain and spinal cord.

Both unilateral and bilateral acoustic neuromas are benign tumors. This means they do not spread to other areas of the body and are not malignant. However, they can still lead to problems if they grow large enough to press on other tissues. This is what can lead to symptoms and lead your doctor to recommend acoustic neuroma treatment by a specialist in NJ.

Bilateral Acoustic Neuroma Symptoms

Now that you understand that an acoustic neuroma develops from the nerve related to hearing and balance, some of the symptoms you have been experiencing likely make more sense. While symptoms of unilateral and bilateral acoustic neuroma are the same, there are two key differences: 1) bilateral acoustic neuromas are on both sides, leading to symptoms on both sides and 2) bilateral acoustic neuroma symptoms (when related to NF2) often develop in teens or early adulthood, versus between 30-60 years old for unilateral acoustic neuromas.

Symptoms often include:

  • Hearing loss or ringing in both ears
  • Difficulty with balance and walking
  • Vertigo
  • Facial numbness or weakness on one or both sides
  • Fluid build-up in the brain (hydrocephalus)

Bilateral Acoustic Neuroma Treatment

Generally speaking, there are three treatment options for acoustic neuroma: monitoring, surgery and Gamma Knife radiosurgery. Your personal doctor will carefully consider your individual condition and health factors to develop the treatment recommendations most appropriate for your specific case. However, it can be helpful to have a basic understanding of the different options available.


Sometimes when an acoustic neuroma is very small and not causing symptoms, a doctor may suggest a schedule of follow-up imaging to ensure it has not grown or changed. However, treatment may become necessary later, which is why it is important to attend any appointments with your doctor. Otherwise, the changes may not be detected as early as possible.


Your doctor may recommend surgery to remove your bilateral acoustic neuroma, especially if your tumors are small and you are a younger patient. The larger the tumor, the greater the risk of damaging delicate structures, such as nerves. However, sometimes a tumor is so large that the surgeon will remove as much of it as possible before following up with Gamma Knife radiosurgery.

Gamma Knife Radiosurgery

Though it sounds like a surgical procedure, Gamma Knife radiosurgery is a specialized form of radiation therapy. There is no hospital stay and no incision, and many patients are able to return to normal activities and work within a couple of days. Gamma Knife radiosurgery can be used to shrink your bilateral acoustic neuroma without damaging adjacent healthy structures. This makes it an excellent choice for treating bilateral acoustic neuroma. It can also be used following surgical resection to eradicate any tumor cells that may remain.

Your Bilateral Acoustic Neuroma

There is a range of treatment options for treating bilateral acoustic neuroma. Though the bilateral is rarer than unilateral acoustic neuroma, there are specialists in the tri-state area who are experienced in the management and treatment of your condition. Gamma Knife radiosurgery is available in northern NJ and has been shown to be a particularly effective treatment in these cases for many patients.

If you find you still have questions about your condition, symptoms or treatment options, be sure to bring them up with your personal doctor at your next appointment. He or she is there to guide you through the entire process, from diagnosis and treatment planning to your procedure and recovery.

Get Your Questions Answered, By a Real Person.

Our Patient Liaison is here to help you understand your next step. After discussing your specific case, she can help you navigate your medical records, answer insurance questions, and connect you with one of our nurses, at no charge to you.

Patient liaisons explain Gamma Knife surgery cost, outcomes, etc.