Radiation Therapy in Acoustic Neuroma

Neuromas or schwannomas of the eighth cranial nerve are benign slow-growing Schwann cell-derived tumors, called acoustic neuromas, or vestibular schwannomas. The incidence is approximately less than 1 per 100,000 persons/ year. Acoustic neuroma has a clinical presentation related to cranial nerve involvement or brainstem and cerebellar compression due to tumor progression. When suspected, clinical diagnosed is confirmed by MRI. The management of vestibular schwannoma is still a quite controversial issue and can include wait and see policy, surgery, and radiotherapy. The treatment choice is based upon the balance between the expected morbidity of the tumor and of the therapy, taking into account also patient’s preference. Medium size (2–3 cm) and large tumors (>3 cm) need an active treatment (surgery or radiotherapy), while smaller tumors can undergo observation as an alternative to active treatment.Epidemiology, clinical presentation, diagnosis, and results of the current treatment options including observation, surgery, and radiotherapy will be presented and discussed.