Progress on the treatment of vestibular schwannoma

Abstract

Vestibular schwannoma is a common benign tumor in the cerebellopontine angle (CPA). The treatment strategy mainly includes follow⁃up observation, stereotactic radiosurgery (SRT) and microsurgery. Although there are still disputes about the standard treatment methods, each method has its advantages and disadvantages. With the deep understanding of tumor progression and various treatment methods, the widely acceptable treatment is follow⁃up observation or SRT for the early asymptomatic vestibular schwannoma. During the follow⁃up period, if the annual tumor growth is more than 2 mm, SRT should be recommended. Large vestibular schwannoma (diameter＞20 mm) can be resected by microsurgery. For large tumors with more ventral growth and severe brain stem compression, relatively conservative surgical strategies such as near total resection (NTR) or subtotal resection (STR) can be considered, supplemented with appropriate SRT. Targeted drug therapy can be used as adjunctive therapy selection for refractory vestibular schwannoma.

doi：10.3969/j.issn.1672⁃6731.2022.12.002