What are the best treatments for Vestibular Schwannoma?

Treatments for Vestibular Schwannoma

Vestibular Schwannoma, also known as acoustic neuroma, is a benign tumor that develops on the vestibular nerve, which connects the inner ear to the brain. While these tumors are non-cancerous, they can cause various symptoms such as hearing loss, tinnitus, dizziness, and balance problems. The treatment approach for vestibular schwannoma depends on several factors including the size and growth rate of the tumor, the severity of symptoms, and the patient's overall health. Here are some of the best treatment options available:

1. Observation

For small vestibular schwannomas that are not causing significant symptoms, a "wait and watch" approach may be recommended. This involves regular monitoring of the tumor's growth through imaging tests such as MRI. If the tumor remains stable and does not cause any complications, treatment may not be necessary.

2. Surgery

Surgical removal is a common treatment option for larger tumors or those causing severe symptoms. The goal of surgery is to completely remove the tumor while preserving the facial nerve and hearing function. There are different surgical techniques available, including:

• Translabyrinthine approach: This involves removing the tumor through an incision made behind the ear. It provides good access to the tumor but results in complete hearing loss.


• Retrosigmoid approach: In this approach, the tumor is accessed through an incision made behind the ear, but the hearing preservation is possible in some cases.


• Middle fossa approach: This technique is used for smaller tumors located near the internal auditory canal. It allows for hearing preservation but may not be suitable for larger tumors.

Surgery carries risks, including potential damage to the facial nerve, hearing loss, and other complications. The choice of surgical approach depends on the tumor size, location, and the patient's individual circumstances.

3. Radiation Therapy

Radiation therapy is an alternative treatment option for patients who are not suitable candidates for surgery or prefer a non-invasive approach. It involves using high-energy beams to target and destroy the tumor cells. There are different types of radiation therapy used for vestibular schwannoma:

• Stereotactic radiosurgery (SRS): This technique delivers a highly focused radiation dose to the tumor while minimizing exposure to surrounding healthy tissues. It is typically a one-time treatment and can be performed using different technologies such as Gamma Knife or CyberKnife.


• Fractionated stereotactic radiotherapy (FSRT): FSRT delivers radiation in smaller doses over multiple sessions. It may be preferred for larger tumors or when preserving hearing is a priority.

Radiation therapy is effective in controlling tumor growth and can help alleviate symptoms. However, it may take months or years to see the full effects, and there is a small risk of radiation-related complications.

4. Hearing Rehabilitation

As vestibular schwannomas can cause hearing loss, hearing rehabilitation may be necessary after treatment. This can involve the use of hearing aids, assistive listening devices, or cochlear implants to improve hearing function and quality of life.

5. Follow-up Care

Regardless of the treatment option chosen, regular follow-up care is essential for patients with vestibular schwannoma. This allows for monitoring of tumor growth, assessment of symptoms, and early detection of any potential complications. Follow-up care may involve periodic imaging tests, hearing evaluations, and consultations with a multidisciplinary team of specialists.

It is important for patients with vestibular schwannoma to discuss their individual case with a healthcare professional to determine the most appropriate treatment approach. The choice of treatment depends on various factors, and a personalized approach is crucial to achieve the best possible outcomes.