Inner Ear Tumours

Overview

The inner ear sits deep within the skull and contains the delicate organs responsible for hearing and balance. Just behind the inner ear is a small space where the hearing, balance and facial nerves travel towards the brainstem. Doctors use the term ‘retro-cochlear’ to describe this hearing nerve system beyond the inner ear.

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About Retro-cochlear Tumours

Tumours or cysts in this area can affect hearing, balance, facial movement or sensation. People may notice symptoms such as hearing loss, tinnitus (ringing), dizziness, imbalance, facial weakness, facial twitching, electric-shock facial pain or pain around the ear and jaw. Some conditions in this region are not tumours but involve pressure or irritation of the cranial nerves, causing pain or muscle spasms. Some tumours grow slowly and cause gradual changes, while nerve compression conditions can produce sudden or severe symptoms.

Inner ear or ‘retrocochlear’ conditions sit close to the brainstem and require assessment by a highly specialist skull base team. They can be benign (non-cancerous) or malignant (cancerous).

Benign (non-cancerous) Tumours

These do not spread to other parts of the body, but they can still cause significant symptoms because they grow close to the hearing, balance and facial nerves:

Vestibular schwannoma / acoustic neuroma – a benign tumour of the balance and hearing nerve
CPA meningioma – a benign tumour near the hearing and facial nerves
Epidermoid cyst of the CPA – a benign congenital cyst that can press on nearby nerves
Other cranial nerve schwannomas (V, VII, IX–XII) – benign tumours arising from the cranial nerves in this region

Malignant (cancerous) Tumours

These are rare but can behave aggressively; cancerous tumours of the cerebellopontine angle (CPA) for example can spread to the space behind the inner ear

Nerve Compression Conditions

These are not tumours, but masses – either caused by blood vessels or cysts – pressing on cranial nerves, leading to pain or muscle spasms. These space-occupying lesions cause a range of nerve-compression syndromes:

Trigeminal neuralgia – this causes severe facial pain due to compression of the trigeminal nerve
Hemifacial spasm – this can cause involuntary twitching caused by compression of the facial nerve
Glossopharyngeal neuralgia – patients may experience throat and/or deep ear pain from irritation of the glossopharyngeal nerve
Geniculate neuralgia – causes deep ear pain from irritation of a branch of the facial nerve
Occipital neuralgia – patients report pain at the back of the head from irritation of the occipital nerves

Retro-cochlear Tumour Treatments

Retrocochlear conditions are complex and sit close to the nerves responsible for hearing, balance and facial movement. Treatment from the Skull Base Specialists depends on the tumour type, size, symptoms and the effect on hearing or facial nerve function.

Some tumours can be monitored with regular scans, while others require surgery or radiotherapy. Nerve compression conditions may be treated with medication, targeted procedures or microsurgery to relieve pressure on the affected nerve. Long-term follow-up often includes hearing tests, imaging and specialist nerve assessments. Click here to learn more about advanced treatment from the Skull Base Specialists.

Overview