ear, nose, and throat disorders
Vestibular Schwannoma
Treatment of Vestibular Schwannoma
Observation Sometimes surgical removal or stereotactic radiation therapy in selected cases Small, asymptomatic (ie, discovered incidentally), and nongrowing vestibular schwannomas do not require treatment; such tumors may be observed with serial MRI scans and treated if they begin growing or cause symptoms. Whether to use stereotactic radiation therapy (eg, gamma knife or cyberknife radiation therapy) or conventional microsurgery depends on many factors including the amount of residual hearing, tumor size, and patient age and health. Stereotactic radiation therapy tends to be used for older patients, those with smaller tumors, or those who cannot have surgery for medical reasons. Microsurgery can involve a hearing-preservation approach (middle cranial fossa or retrosigmoid approach) or a translabyrinthine approach if there is no useful residual hearing. 