Acoustic Schwannomas

Abstract

After arteriovenous malformations, acoustic schwannomas have been the most rewarding condition to treat in the Gamma Knife, which is reflected by the large number of patients treated world wide. Nonetheless, the correct way to treat this difficult condition is a matter of debate. Surgery may be performed, by the translabyrinthine approach by an ENT surgeon. It may also be performed through the posterior fossa by a neurosurgeon. Ideally both forms of surgery may be available with collaboration between the specialities involved. A third operation, through the middle fossa has been reserved for hearing preservation in small, primarily intracanalicular tumours. Another quite different form of treatment is of course that provided by the Gamma Knife. In 1991 two major assessments of acoustic treatment were presented. One was an article summing up the results of a century of treatment. The other was the first international acoustic “neuroma” conference held in Copenhagen, where top expertise from all relevant specialities and most parts of the world were present. On the basis of data provided from these two sources, it is fair to say that there is a considerable range of opinion on the subject of what constitutes optimal treatment.