title: [I beg your pardon? I can be treated by another modality than surgery for my vestibular schwannoma].
abstract: The history of the treatment of vestibular schwannoma (VS) clearly shows a shift from microsurgery towards radiotherapy as "standard therapy". The microsurgical approach obviously yields excellent tumour control, but is hampered by a high morbidity rate, especially at the level of cranial nerves. The literature reports a normal facial nerve function in only 60% of patients surgically treated for VS with a maximum diameter of 25 mm. Hearing preservation is only around 15% for tumours > 15 mm and around 50% for tumours less than 15 mm. Progress in techniques and computer sciences in the field of radiotherapy provides the opportunity to reach high levels of tumour control (92 - 98%), keeping cranial nerve morbidity on a very low level (< 2%). Hearing capacity and serviceable hearing can be maintained in about 70% of cases. Based on these results, one can assume that radiation therapy should be used upfront for those benign tumours.
authors.affiliation: Service de Radiothérapie Universitaire, CHU de Liège, Belgique. pcoucke@chu.ulg.ac.be
authors.forename: Ph
authors.initials: P
authors.lastname: Coucke
authors.forename: Z L
authors.initials: ZL
authors.lastname: Janvary
authors.forename: V
authors.initials: V
authors.lastname: Baart
authors.forename: M
authors.initials: M
authors.lastname: Devillers
authors.forename: N
authors.initials: N
authors.lastname: Jansen
authors.forename: E
authors.initials: E
authors.lastname: Lenaerts
mesh_terms: D019583:Dose Fractionation, Radiation; D006801:Humans; D009464:Neuroma, Acoustic / Q000601:surgery*; D016634:Radiosurgery