title: Management of acoustic schwannoma.
abstract: OBJECTIVE
  To discuss the optimal management for patients with acoustic schwannoma.
  
  
  METHODS
  Review of the pertinent literature.
  
  
  RESULTS
  Microsurgery, stereotactic radiosurgery, and fractionated radiotherapy result in cure rates that approximate 90% at 5 years. Depending on tumor extent and surgical approach, the morbidity of microsurgery may exceed that of stereotactic radiosurgery and fractionated radiotherapy. Patients with useful hearing before treatment may have a higher likelihood of hearing preservation after radiotherapy compared with radiosurgery.
  
  
  CONCLUSIONS
  Both microsurgery and radiosurgery are good options for patients with tumors less than 3 cm. Depending on tumor extent and the surgical approach, the morbidity of microsurgery may exceed that of radiosurgery. Patients with useful hearing may have a higher likelihood of hearing preservation after radiotherapy. Microsurgery is preferred for patients in whom the disease progresses after initial irradiation and in patients with tumors larger than 3 cm.
authors.affiliation: Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, 32610-0385, USA. mendewil@shands.ufl.edu
authors.forename: William M
authors.initials: WM
authors.lastname: Mendenhall
authors.forename: William A
authors.initials: WA
authors.lastname: Friedman
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Amdur
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Antonelli
mesh_terms: D003131:Combined Modality Therapy; D006801:Humans; D008866:Microsurgery; D009464:Neuroma, Acoustic / Q000532:radiotherapy* / Q000601:surgery*; D016634:Radiosurgery