Radiosurgery for intracanalicular vestibular schwannomas.

Advances in central nervous system imaging have resulted in early detection of a greater number of intracanalicular vestibular schwannomas. Early detection of intracanalicular vestibular schwannomas raises the issue of whether or not treatment is required and, if so, whether radiosurgery is the most appropriate option. Available evidence indicates that a majority of intracanalicular lesions are observed to grow and most will be associated with progressive hearing loss or, less frequently, sudden persistent hearing loss. If the objective of treatment is to preserve serviceable binaural hearing, early intervention is advisable. Early intervention is advantageous only if serviceable hearing can be maintained in the majority of patients along with low perioperative morbidity. Radiosurgery seems to achieve these goals ideally. Radiosurgery is a minimally invasive management option for patients with intracanalicular tumors. Radiosurgery provides high rate of long-term hearing preservation with minimal morbidity.