[An update on the treatment of vestibular schwannoma]

The increase in the diagnosis of ever smaller vestibular schwannomas (VS), the fact that many tumours can be observed with serial MRI, and the development of radiosurgery as an alternative to microsurgery have led the neurotologic surgeon to a new global approach to patients with VS. On the other hand, the spread of internet-based information sources, often with biased or incomplete information, makes counselling patients with VS a challenging task. This study provides an overview of the natural history of these tumours and the main therapeutic options: observation, surgery and radiosurgery, with comments on their indications, advantages and disadvantages. Due to the completely different approach and peculiar features of bilateral VS in patients with type II neurofibromatosis, these are excluded.