Brazilian Society of Otology task force - Vestibular Schwannoma ‒ evaluation and treatment

Braz J Otorhinolaryngol. 2023 Nov-Dec;89(6):101313. doi: 10.1016/j.bjorl.2023.101313. Epub 2023 Aug 28.

Abstract

Objective: To review the literature on the diagnosis and treatment of vestibular schwannoma.

Methods: Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on vestibular schwannoma were eligible for inclusion. The American College of Physicians' guideline grading system and the American Thyroid Association's guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions.

Results: The topics were divided into 2 parts: (1) Diagnosis - audiologic, electrophysiologic tests, and imaging; (2) Treatment - wait and scan protocols, surgery, radiosurgery/radiotherapy, and systemic therapy.

Conclusions: Decision making in VS treatment has become more challenging. MRI can diagnose increasingly smaller tumors, which has disastrous consequences for the patients and their families. It is important to develop an individualized approach for each case, which highly depends on the experience of each surgical team.

Keywords: Auditory brain stem implants; Cochlear implant; Hearing loss, sensorineural; Neurofibromatosis 2; Neuroma, acoustic; Radiotherapy; Single sided deafness; Surgery; Vestibular schwannoma.

Publication types

  • Review
  • Practice Guideline

MeSH terms

  • Advisory Committees
  • Brazil
  • Humans
  • Magnetic Resonance Imaging
  • Neuroma, Acoustic* / diagnostic imaging
  • Neuroma, Acoustic* / physiopathology
  • Neuroma, Acoustic* / therapy
  • Otolaryngology / standards
  • Radiosurgery
  • Societies, Medical*