Intracanalicular vestibular schwannomas. Observation, radiosurgery or microsurgery – what to choose?

The review examines the epidemiology of vestibular schwannomas (VS), classification, the pathogenesis of the main clinical symptoms of small tumors located in the internal auditory canal (intracanalicular), the principles of diagnosis and various treatment options. The main directions of curation of patients with intracanalicular VS are analyzed: observation, radiosurgery and microsurgery. The main advantages and disadvantages of the methods used are considered: observation is advisable in the absence of VS growth, with initially safe hearing or with completely lost hearing. Radiosurgery has a high chance of preserving hearing, including functional, and provides control of VS growth in more than 90 %. There is currently insufficient data to recommend microsurgery as the first choice in the treatment of intracanalicular VS.