Salvage Management of Vestibular Schwannoma

Otolaryngol Clin North Am. 2023 Jun;56(3):557-565. doi: 10.1016/j.otc.2023.02.014. Epub 2023 Mar 22.


The current management of vestibular schwannomas (VS) includes observation, microsurgery (MS), and stereotactic radiosurgery (SRS) or radiotherapy, and treatment failures may occur with any primary modality. SRS is most often used for microsurgical failures, as it carries a low risk of adverse events. Salvage MS following previous MS is reserved for specific cases and can present certain surgical challenges. Irradiation failures can be managed with both salvage MS and repeat SRS. This article is intended to review an approach to the failure of primary interventions for VS, with a focus on the time interval between modalities, rates of tumor control, functional outcomes, and possible complications.

Keywords: Functional outcomes; Microsurgery; Revisions; Stereotactic radiosurgery; Treatment failures; Vestibular schwannomas.

Publication types

  • Review

MeSH terms

  • Humans
  • Microsurgery
  • Neuroma, Acoustic* / therapy
  • Neurosurgical Procedures
  • Radiosurgery* / adverse effects
  • Retrospective Studies
  • Treatment Outcome