An Acoustic Neuroma is a benign, slow-growing tumor that originates in the canal connecting the brain to the inner ear. Vestibular Schwannoma is another more accurate name for this type of benign tumor (regarding the location of the tumor).

HISTORY:

34 year old man (RM) with history of right sided hearing loss and mild balance issues. Investigations by Medical Specialist revealed right Acoustic Neuroma which was removed by an ENT Surgeon via retrosigmoid excision. Planned return to work (as an Electrician) as soon as able, but experiencing ongoing visual blurring with related loss of balance, stiffness trunk and neck, and right facial weakness particularly right eye closure. Discharged home from hospital four days post-op with planned Vestibular physiotherapy assessment one week later.

EXAMINATION:

RM able to walk independently, but mild veering particularly to the left, especially if asked to visually scan whilst walking. Static standing balance affected – eyes closed balance = 13 seconds only. High level balance skills also significantly affected with eyes open. Oculomotor testing revealed a marked difference between head still and head moving visual acuity, verifying his symptoms of visual blurring and associated imbalance with head movement.

TREATMENT:

Initial weekly treatment for progression of Adaptation exercises to stabilise his visual gaze and balance exercises with visual and unstable surface challenges to aim to achieve his goal of return to work requiring these skills at a high level of precision, as soon as able.

OUTCOME:

RM made excellent recovery over a four week period by diligent undertaking of his progressive home program and returned to work after one month’s rehabilitation. He returned for a monthly review to check progress and work status, and was discharged with review only if needed.