[I beg your pardon? I can be treated by another modality than surgery for my vestibular schwannoma]

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.