Background Very few studies have examined vestibular schwannoma (VS) management trends across
centers and between providers. The objective of the current study is to examine current
practice trends, variance in treatment philosophies, and nuanced or controversial
aspects of VS care across North America.
Methods Cross-sectional survey of North American Skull Base Society (NASBS) members who report
regular involvement in VS care.
Results A total of 57 completed surveys were returned. Most respondents claimed to have over
20 years of experience and the majority reported working in an academic practice with
an affiliated otolaryngology and/or neurosurgery residency program. Sixty-three percent
of respondents claimed to evaluate VS patients in clinic with both an otolaryngologist
and neurosurgeon involved. Eighty-six percent of respondents claimed to operate on
VS with both an otolaryngologist and neurosurgeon involved, while only 18% of neurosurgeons
and 9% of otolaryngologists performed surgery alone. There was a wide range in the
number of cases evaluated at each center annually. Similarly, there was wide variation
in the number of patients treated with microsurgery and radiation at each center.
Additional details regarding management preferences for microsurgery, stereotactic
radiosurgery, stereotactic radiotherapy, and conservative observation are presented.
Conclusion Vestibular schwannoma management practices vary between providers and centers. Overall,
most centers employ a multidisciplinary approach to management with collaboration
between otolaryngology and neurosurgery. Overall, survey responses concur with previous
studies suggesting a shift toward conservatism in management.
