History of vestibular schwannoma surgery.

Attempts of surgical removal of vestibular schwannomas started 150 years ago with major limitations in terms of diagnosis and understanding of the disease but also in respect of surgical technique and instrumentation. Then came Cushing followed by Dandy, two pioneers and legendary neurosurgeons who understood the natural history of the disease and set the landmarks of the current surgery of the cerebellopontine angle. In this century of medicine, results and expectations shifted from a life-threatening affection to the actual standard of cranial nerve preservation and conservation of quality of life. In this overview, it is shown how the standard of the current surgery came from two distinct medical cultures, otologists and neurosurgeons, respectively. Now and in the near future, these competencies will be gathered in multidisciplinary teams who will display the whole panel of the treatment options in order to offer the best individual solutions for the patients.