Understanding Facial Numbness, Dry Eye, and Taste Changes After Acoustic Neuroma

Living with the aftermath of acoustic neuroma surgery can be confusing, frustrating, and at times, deeply isolating. Some common symptoms include facial numbness, weakness in jaw, constant dryness in the eye, and a strange, salty or metallic taste that comes and goes. In my case, I also notice small cuts on my tongue and an odd heaviness that makes it feel clumsy and unfamiliar. These symptoms are real, and they don’t just affect the body — they affect the spirit. But over time, I have come to understand that knowing why they happen can ease some of the fear. Today, I want to explain why they occur and remind you that you don’t need to become a neurologist to make sense of what’s happening to your body. A little knowledge can go a long way in helping you accept your situation, keep realistic expectations, and avoid unnecessary worry.

Understanding the Condition

Acoustic neuroma/ vestibular schwannoma forms on the vestibulocochlear nerve (cranial nerve VIII). This nerve controls hearing and balance and is located deep near the inner ear at the base of the brain.

Because of its location, the tumour can also affect nearby cranial nerves, including:

• Cranial Nerve VII (Facial Nerve): Controls facial muscles, blinking, and tear production.
• Cranial Nerve V (Trigeminal Nerve): Responsible for facial sensation and chewing.
• Cranial Nerve XII (Hypoglossal Nerve): Controls tongue movement.
• Cranial Nerve IX (Glossopharyngeal Nerve): Involved in taste from the back of the tongue and swallowing.

Whether from tumour pressure or surgery, these nerves may be stretched or irritated, causing long-term symptoms.
Unfortunately, nerves heal very slowly. Some symptoms may persist for months or even years and in some cases, they may never fully improve.

My Symptoms and How They Connect to Nerve Function

Facial Numbness

My left cheek feels disconnected — a bit like after a dental anaesthetic. This is due to the trigeminal nerve (CN V). I often touch or scratch the area not out of irritation, but to feel something again.

Jaw Weakness

Chewing on the left side has become difficult. That is because the mandibular branch of CN V controls the chewing muscles. I now rely more on the right side when eating.

Eye Dryness

My left eye is extremely dry with almost no tear production. This is regulated by the facial nerve (CN VII). I use preservative-free artificial tears multiple times a day to protect the eye and maintain comfort.

Tongue Changes

After surgery, I developed small cuts on the left side of my tongue. This could be due to issues with the hypoglossal nerve (CN XII) — which affects tongue movement — or the lingual branch of CN V, which affects sensation. My tongue sometimes feels clumsy or less coordinated.

A Salty Taste in One Tooth

One of my tooth tastes salty. This can be explained by injury to the chorda tympani, a branch of CN VII that handles taste from the front of the tongue. Nerve signal disruption can lead to phantom tastes like saltiness or metal.

What Helps Me Cope

• Preservative-free artificial tears: Essential for preventing eye damage and maintaining comfort.
• Facial massage: Light massage around the numb area helps improve circulation and awareness. Be cautious with heat or sharp objects near numb areas.
• Mindful chewing: I chew slowly and deliberately to avoid tongue injury and make eating more manageable.
• Hydration and sugar-free gum: Drinking water and chewing gum helps reduce odd taste sensations.

If anything worsens or you notice new changes, it’s wise to consult a neurologist, facial nerve specialist, or a speech and swallow therapist for more targeted care.

The Road Ahead

Healing from acoustic neuroma is unpredictable. Some functions return slowly — others may stay changed. And that is acceptable.

I used to look in the mirror and feel disconnected from my face. But the first time I saw a small twitch — a flicker of hope — I knew I was still healing. Not just physically, but emotionally.

The former version of myself might not return exactly. But this journey has taught me resilience, self-compassion, and strength.

Whether you are facing numbness, dry eyes, tongue injury, or emotional fatigue — you are not alone.

Let go of who you were supposed to be, and embrace the person you are becoming.

Take it one day at a time. Ask for help. And never stop showing up for yourself.