Conservative Management of Vestibular Schwannomas

Conservative Management of Vestibular Schwannomas
John Rutka

The experience from the University Health Network, University of Toronto is presented that looked at a cohort of 72 patients with small to medium sized VS’s followed for 10 years in a prospective study. In conjunction with other published reports there has been a paradigm shift in the management of patients with VS’s. Results from this study allowed us to determine the difference in growth rates between IAC vs CP angle tumors, failure rates (40% over 10 years), economic implications of conservative (very favorable overall) vs active approaches (gamma knife vs microsurgery), hearing change in conservative vs stereotactic Rxt management etc. This incorporated a series of studies that ultimately was a game changer in the way VS’s were managed in the UK and North America (trends in the US now seem to demonstrate this as well).