A pilot with an intravestibular Schwannoma: to fly or not to fly?

Objective: To report on the professional repercussions of an intravestibular schwannoma in a commercial airline pilot. Patients: The case of a single patient with a unilateral intravestibular schwannoma. Intervention: Return to a flying status with specific restrictions and under tight conditions depending on the outcomes of a mandatory periodic watch-and-rescan policy. Main Outcome Measures: Consecutive magnetic resonance imaging results coupled to the clinical otovestibular status of the patient. Results: After 16 uneventful months of flying, the pilot was grounded after a first episode of vertigo. Conclusion: The combination of an intravestibular schwannoma-as one of the rarest intralabyrinthine schwannomas-and a pilot-for whom proper otovestibular functioning is of the uppermost importance-challenges the responsibilities of all involved. Depending on the clinical circumstances and under tight conditions with specific restrictions, a return to a flying status can very exceptionally be considered. An open discussion and the establishment of a relation of mutual trust are felt to be an absolute prerequisite.