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Clinical Challenges
August 2003

Microsurgery vs Gamma Knife Radiosurgery for the Treatment of Vestibular Schwannomas

Author Affiliations




Arch Otolaryngol Head Neck Surg. 2003;129(8):903-906. doi:10.1001/archotol.129.8.903

Hypothesis: Microsurgery is the best therapy for most acoustic neuromas.

Vestibular schwannomas are benign Schwann cell tumors that arise from the vestibular portion of the eighth cranial nerve. They are found within the internal auditory canal and cerebellopontine angle, and the yearly incidence is 1 per 100 000. Vestibular schwannomas account for approximately 6% of all intracranial tumors, and they are the most common tumor of the cerebellopontine angle.1 Patients with vestibular schwannomas usually present in the fifth or sixth decade of life with a variety of complaints, including hearing loss and dizziness. Diagnostic imaging of vestibular schwannomas has evolved over the years. The gold standard for diagnosis of these tumors is gadolinium-enhanced magnetic resonance imaging,2 which has allowed for the diagnosis of smaller tumors than in years past. The natural history of these tumors is steady growth at approximately 2 mm per year, although an unpredictable population of tumors seems to have a faster growth rate.3,4