Conservative management of vestibular schwannoma.

Summary. In the last decades, an increasing incidence of vestibular schwannoma (VS) has been reported and small/medium sized tumours are more frequently detected. Therefore, considering the slow or absent growth rate of the tumour, a conservative management of VS is sometimes adopted. Between January 1990 and March 2004, 84 patients affected by VS were primarily observed with the \u201cwait and scan\u201d policy (83 subjects with unilateral VS and one subject with bilateral VS). All the patients were examined by MRI and the mean follow-up period was 4.5 years. In 54/85 (63.5%) cases no growth was detected during the entire follow-up period (three cases with tumour shrinkage), while in the remaining 31/85 (36.4%) cases a volumetric increase was recorded. Our results strongly confirm that in some circumstances the \u201cwait and scan\u201d policy may be a reasonable choice of management of VS; nevertheless, the behaviour of the tumour is quite irregular and periodic MR scans are mandatory. Useful information may be expected by a further extension of both the group of study and the follow-up period