Diagnosis – What's Next?

Receiving an acoustic neuroma diagnosis can be overwhelming, and it’s normal to feel anxious or uncertain about the road ahead. Understanding your diagnosis, gathering baseline information, and seeking emotional support, is an important first step in navigating your journey.

Understanding Your MRI Results

Your MRI is the primary tool for diagnosing and monitoring an acoustic neuroma. Key details to pay attention to include:

• Size of the tumour: Larger tumours may affect surrounding structures more significantly, but even small tumors can impact hearing, balance, or facial nerves
• Classification / Location: Tumours are often classified by their location in relation to the internal auditory canal and the cerebellopontine angle. This helps your medical team understand which nerves or brain structures could be affected
• Proximity to critical structures: Tumours close to the brainstem or vital nerves may require prompt treatment, or careful monitoring and assessment of potential risks
• Growth pattern: Your MRI may provide insight into whether the tumour appears stable or shows signs of growth over time. For small tumours, a repeat MRI is typically recommended between 6 months - 1 year to establish rate of growth before recommending treatment. 

Important: Always ask your doctor or specialist if you need help interpreting your MRI results. Each case is unique, and your healthcare team is the best source for explaining what your scan means for you.

Acoustic neuromas vary in size, location, and impact. Understanding your tumour type is the first step toward choosing the right treatment.

Tumour Classifications

• Small — under 1.5 cm
• Medium — 1.5 to 2.5 cm
• Large — over 2.5 cm

Large or intracranial tumours can increase pressure in the skull, may be life-threatening, and typically require immediate intervention.

Questions you may want to ask your doctor about your MRI:

• What is the size and exact location of my acoustic neuroma?
• Is the tumour pressing on my brainstem, hearing nerve, balance nerve, or facial nerve?
• How often should I have follow-up MRIs?
• Does the MRI show signs of tumour growth, or is it stable?

Baseline Testing

Before starting any treatment, baseline testing is recommended, particularly for patients experiencing hearing loss, balance issues, facial nerve symptoms, or cognitive changes. Establishing a pre-treatment baseline helps your healthcare team:

• Assess your current level of function
• Gauge treatment outcomes and recovery
• Detect subtle changes over time

Note: In some urgent cases, there may not be time to complete baseline testing before moving forward with treatment. Your healthcare team will guide you on what is most important and time-sensitive in your situation.

Recommended Testing

Before treatment, baseline assessments help your team measure function and plan care:

• Hearing: Audiologist evaluates current hearing levels and speech understanding
• Balance: Vestibular specialist assesses vestibular (inner ear) function and coordination
• Ear & Nerve Health: ENT / Otologist / Neurotologist examines ear structures and nerve function to guide surgical planning
• Facial Nerve Function: Neurologist assesses facial muscle strength, movement, and baseline nerve health
• Cognitive Function: Neuropsychologist evaluates memory, attention, and processing, which can be affected by vestibular disorders and/or tumour-related stress
• Visual & Eye Movements: Ophthalmologist or neuro-ophthalmologist checks vision and records involuntary eye movements (nystagmus), which can be linked to vestibular dysfunction

Why it matters:

Establishing these baseline measurements allows your treatment team to accurately monitor changes, optimize care, and maximize functional outcomes—physically, cognitively, and in daily life.

Emotional Support

A diagnosis can be emotionally challenging. You are not alone:

• Reach out to family, friends, or support networks for comfort and encouragement
• Connect with patient organizations and communities for shared experiences and practical advice
• Seek counseling or professional support, especially with providers who specialize in medical trauma or neurological conditions. These professionals can help you process the emotional impact of diagnosis and adjust to changes in daily life.

Important: Acknowledging and addressing your emotional well-being is just as important as understanding the medical details!

Next Steps

Focus on gathering information, completing baseline tests, and building your support network. This foundation will help you feel informed and prepared as you move forward in your journey.