Vestibular schwannomas: Key research questions and priorities

Vestibular schwannomas (VS) are the most common tumors in the cerebellopontine angle and represent one of the most challenging skull-base tumors to treat. Over the past decade, studies have significantly improved our understanding of the natural history of these tumors and the genetic alterations that lead to their development. Nevertheless, a number of key questions remain unanswered in VS, including the development of prognostic molecular biomarkers and biomarkers associated with hearing loss, the role of microsurgical resection vs SRS in tumors that are eligible for both modalities, the role of adjuvant radiotherapy, and treatment of VS in patients with NF2-related and other schwannomatoses. In this chapter, we introduce the genomic alterations underlying VS development before addressing each of the above topics in detail. We note that while we briefly discuss the treatment of VS in NF2 patients, this topic is more comprehensively discussed in Chapter 8.