Acoustic Neuroma Guidelines

Updated: Apr 10, 2018
  • Author: Joe Walter Kutz, Jr, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Guidelines

Guidelines Summary

In 2018, the Congress of Neurological Surgeons released a series of guidelines on the diagnosis and management of vestibular schwannomas. [14, 15, 16, 17, 18, 19] The group’s guidelines concerning hearing preservation in patients with sporadic vestibular schwannomas include the following [20] :

  • Patients whose baseline hearing meets the criteria for American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) class A or Gardner-Robertson hearing classification (GR) grade I and who are considering stereotactic radiosurgery utilizing modern dose planning, should be counseled that there is a high probability (>75-100%) of hearing preservation at 2 years, a moderately high probability (>50-75%) of hearing preservation at 5 years, and a moderately low probability (>25-50%) of hearing preservation at 10 years
  • Patients with AAO-HNS class A or GR grade I hearing at baseline who are considering microsurgical resection of small to medium-sized sporadic vestibular schwannomas should be counseled that there is a moderately high probability (>50-75%) of hearing preservation immediately following surgery, a moderately high probability (>50-75%) of hearing preservation at 2 years, a moderately high probability (>50-75%) of hearing preservation at 5 years, and a moderately low probability (>25-50%) of hearing preservation at 10 years
  • Patients with AAO-HNS class A or GR grade I hearing at baseline should be counseled that, if they undergo management with conservative observation, there is a high probability (>75-100%) of hearing preservation at 2 years and a moderately high probability (>50-75%) of hearing preservation at 5 years; insufficient data were available to determine the probability of hearing preservation at 10 years for these patients