LINAC stereotactic radiosurgery for vestibular schwannomas

Abstract

Vestibular schwannomas, though typically benign, can often be managed through several options including observation/surveillance, microsurgery, stereotactic radiosurgery, and fractionated radiotherapy. With the advent of linear accelerator (LINAC)-based stereotactic radiosurgery, the option of radiation as a treatment modality has become more accessible. This chapter revisits the epidemiology and pathophysiology of vestibular schwannomas and discusses LINAC-based stereotactic radiosurgery options often used in their management. Current consensus guidelines have been discussed with an emphasis on the key published literature regarding the outcomes for tumor recurrence, facial and trigeminal palsies, and other rare sequelae post-LINAC-based radiosurgery for vestibular schwannomas. LINAC-based stereotactic radiosurgery is shown to be an excellent modality for treating vestibular schwannomas, with good outcomes in tumor control and preservation of cranial nerve function.

Keywords: Acoustic neuroma; CyberKnife; LINAC; Linear accelerator; Neurofibromatosis; Stereotactic radiosurgery; Vestibular schwannoma; Zap; Zap-X.