What intervention is best practice for vestibular schwannomas? A systematic review of controlled studies

Objective: Largely, watchful waiting is the initial policy for patients with small-sized or medium-sized vestibular schwannoma, because of slow growth and relatively minor complaints, that do not improve by an intervention. If intervention (microsurgery, radiosurgery or fractionated radiotherapy) becomes necessary, the choice of intervention appears to be driven by the patient’s or clinician’s preference rather than by evidence based. This study addresses the existing evidence based on controlled studies of these interventions. Design: A systematic Boolean search was performed focused on controlled intervention studies. The quality of the retrieved studies was assessed based on the Sign-50 criteria on cohort studies.