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  ADVANCES IN OTOLARYNGOLOGY IN 2011 

Otorinolaringologia 2011 December;61(4):189-96

Copyright © 2011 EDIZIONI MINERVA MEDICA

language: English

Contemporary management of vestibular schwannomas: surgical approaches, pros and cons

Gouveris H., Mann W.

Department of Otorhinolaryngology Head and Neck Surgery, The University of Mainz Hospitals and Clinics, Mainz, Germany


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Options for the management of patients with vestibular schwannoma include observation and active treatment, namely surgical resection, gamma knife stereotactic radiosurgery or fractionated radiation therapy. Although for large tumors microsurgery still remains the mainstay of treatment, management of the small- and medium-sized vestibular schwannomas remains controversial. Microsurgical techniques for the treatment of vestibular schwannomas include the retrosigmoid approach, middle fossa approach and translabyrinthine approaches. When a surgical solution is indicated, existing published evidence on a number of clinical parameters may assist both the clinician and the patient make an informed decision on the precise surgical approach needed. The most important among the multitude of clinical parameters include the facial nerve function (both motor and sensory components), hearing, balance, tinnitus, headache, cerebrospinal fluid leak and quality of life measures. By comparing published evidence on the aforementioned parameters involving each one of the three surgical procedures, the surgeon may be in a position to better counsel the vestibular schwannoma patient.

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