Vestibular schwannoma: when is radiosurgery an option?

What is a vestibular schwannoma?

Also called an acoustic neuroma, it is a usually benign tumour arising from the balance nerve, close to the hearing nerve. It may cause hearing loss, tinnitus or imbalance, although some people have no symptoms. MRI is central to assessing and monitoring the tumour.

Why is treatment not always needed?

Some vestibular schwannomas grow very slowly or remain stable. For small, minimally symptomatic tumours, surveillance with MRI and hearing tests may be appropriate. Growth, progressive symptoms or pressure on nearby structures may change the recommendation.

When can radiosurgery help?

Radiosurgery may control growth of selected small or medium-sized tumours without an open operation. It does not usually make the tumour disappear quickly and cannot guarantee restoration of lost hearing. Large tumours, especially those pressing on the brainstem, may need surgery.

Which functions need protection?

Planning takes account of residual hearing, the facial nerve, nearby nerves and the brainstem. Hearing can still worsen over time, and balance difficulties, numbness or facial weakness are possible, depending on the individual case.

Questions for your appointment

Is my tumour growing? What is my current hearing level? What are the relative risks of observation, surgery and radiosurgery? How will MRI and audiology follow-up be organised?