How Can Radiotherapy For Acoustic Neuromas Keep You Driving?

If you are diagnosed with an acoustic neuroma, it is distinctly possible that you will have had this benign tumour for years without even knowing about it. They grow slowly and often only come to light when symptoms emerge.

Sometimes referred to as a vestibular schwannoma, an acoustic neuroma grows in the inner ear and is located on the vestibulocochlear nerve, which is the main nerve connecting the ear to the brain.

What Are The Symptoms Of Acoustic Neuromas?

Although it is close to the brain, it is not a brain tumour. Emerging from the Schwann cells in the ear, tumours of this type are not cancerous, but once they grow large enough, they can start to have a number of effects. Symptoms can include:

• Numbness or weakness in the facial muscles
• Loss of balance
• Dizziness
• Tinnitus
• Loss of hearing
• These tumours usually only affect one ear

If the tumour is left untreated and grows particularly large, further symptoms can arise:

• Headaches caused by pressure on the brainstem
• More severe balance and walking difficulties (Ataxia)
• Hydrocephalus, a dangerous build-up of cranial fluid
• Voice changes caused by pressure on the lower cranial nerves

Once the tumour is large enough, it can press against the brain, which can contribute to balance problems and dizziness, but the impact on the vestibulocochlear nerve contributes to all the above symptoms, as the inner ear is responsible for balance.

Tinnitus and loss of hearing are the most obvious direct impacts on hearing itself, the first of which impacts nine out of ten people with this tumour once it is large enough for symptoms to arise.

How Can Drivers Be Affected By Acoustic Neuromas?

These symptoms can reduce the quality of life for sufferers in several ways. As well as the experience of the symptoms themselves, it may also prevent sufferers from being able to drive.

A recent reminder from the Driver and Vehicle Licensing Authority (DVLA) has told motorists that they need to report certain disabilities and may face prosecution and a heavy fine if they do not. The list of disabilities includes acoustic neuromas.

Since dizziness and the potential impact of hearing loss, such as not hearing an approaching vehicle, could endanger drivers and other road users, this is logical. As with any disability, the key is to let the DVLA know and allow them to make a decision.

However, this could mean a licence being suspended if the DVLA deems that the driver is unfit to be behind the wheel due to the severity of their symptoms.

This adds to the reasons to seek acoustic neuroma treatment at the earliest stage possible. The first step is to see a doctor when symptoms arise to get a diagnosis.

How Are Acoustic Neuromas Treated?

Provided a scan confirms the presence of the tumour, treatment can then be planned to tackle the neuroma.

Our experts in the field will carry out an examination and, in full consultation with each patient, decide the best course of treatment.

There are three treatment options:

• Observation, which is possible with slow-growing tumours that are not yet manifesting serious symptoms
• Surgery to remove part or all of the tumour
• Radiotherapy to shrink the tumour, or whatever part of it remains after surgery

If the situation is such that a patient is suffering sufficiently major symptoms that they have to surrender their driving licence, observation will not be a viable course of action.

Surgery can bring some significant benefits by restoring balance and taking away the pressure that can lead to facial numbness. It can also prevent further hearing loss, although it cannot restore any hearing lost already.

What Kind Of Radiotherapy Is Used To Treat Acoustic Neuromas?

The kind of radiotherapy used in this situation is stereotactic radiotherapy. This involves using state-of-the-art equipment to direct beams of very powerful radiation with great precision at the tumour. This damages the tumour’s DNA, inhibiting cell reproduction.

This is an especially effective way of shrinking a tumour while minimising radiation exposure to sensitive tissue around it in the ear and brain.

It is not used on larger tumours, which are prime candidates for surgery, but the main benefit of stereotactic radiosurgery is that it is effective in targeting small areas, making it especially well-suited to small tumours.

With effective treatment, patients may find that a range of symptoms caused by an acoustic neuroma are eased or, in the case of hearing loss, do not get worse. A hearing aid may then enhance audio function in the affected ear.

This can bring great improvements in the quality of life of each patient. This may include enabling them to successfully apply to get their driving licence restored, or preventing the symptoms from progressing to the point where they would have to relinquish it to begin with.

Learn more about our advanced radiotherapy and neurosurgical treatments for Acoustic Neuromas on the Queen Square website.