Acoustic neuroma may be difficult to detect and diagnose since symptoms can take years to manifest and are usually similar to other middle ear problems. The earliest symptoms of the condition would be ipsilateral sensorineural loss of hearing or deafness, gait alteration, disturbed sense of balance, vertigo with associated nausea, ear pressure and vomiting. Tinnitus is also a common symptoms experienced by over 80% of patients which is characterized by unilateral high-pitched ringing in the ears. A small tumor is referred to as intracanalicular since it remains inside the bony internal auditory canal that will produce symptoms like hearing loss, tinnitus, dizziness or vertigo. A medium-sized tumor extends into the brain cavity without pressing on the brain which will produce symptoms like greater hearing loss, headaches together with vertigo, facial numbness, reduced eye sensation and difficulty balancing. A large tumor extends into the brain cavity and presses on the brain producing symptoms like facial twitching and weakness, hydrocephalus, headache, double vision, loss of taste, altered gag and swallowing reflex and visual loss. There are a number of diagnostic tools to confirm acoustic neuroma after noticing the signs and symptoms. Computed Tomography or CT scan of the head will be able to show the presence of tumors larger than 2 centimeters in diameter and projecting over 1.5 centimeters into the cerebellopontine angle. Magnetic Resonance Imaging or MRI will also detect growths. Audiology and vestibular tests will check the severity of hearing loss through air conduction and bone conduction. There are three main treatment approaches for acoustic neuroma namely observation, partial or total microsurgical removal and radiation. If the tumor remains small or growth is very slow with no signs or symptoms, the doctor may opt to monitor the patient regularly only to prefer other alternatives if the condition becomes worse. Imaging and hearing tests will be done regularly as scheduled by the doctor to constantly check any signs of progress. Total or partial microsurgical removal refers to manually removing the tumor by creating an incision in the patient's skull. This is a preferred option if the tumor is getting large and pressing on the brain. Radiation involves radiation beams being directed and applied on the tumor site. This is used if the patient does not like having a skull incision. The effects take longer as well and do not damage brain tissue. The risk of surgery and radiation is permanent hearing loss.