Vestibular Schwannomas: Diagnosis and Surgical Treatment

Abstract

Over the last decades, significant advances in skull base surgery have enabled many neurosurgical centers around the world to perform surgical resection of vestibular schwannomas; otherwise, clinical observation and radiotherapy/radiosurgery can be possible management options. Auditory pattern, the presence of bilateral tumors, tumor size, and neurological symptoms are deeply considered in the decision-making process. In this chapter, we expanded the general discussion of vestibular schwannomas, discussing bases for an accurate diagnose and the technical aspects for the surgical approaches, drilling of internal auditory canal, and its reconstruction as well as the technical nuances when handling very small and large/ residual tumors.

Hearing preservation surgery for vestibular schwannoma: a systematic review and meta-analysis

“…The middle fossa (MF) or sub-temporal approach allows hearing preservation by reaching the IAC from above. It is indicated in young patients with good preoperative hearing function affected by VSs limited to the IAC or with only minimal (< 0.5 cm) extra-meatal extension 11 .…”