Vestibular Schwannomas Guidelines

Introduction: The publication of the Congress of Neurological Surgeons (CNS) Vestibular Schwannomas guidelines last year was remarkable.

With the wonderful help from the CNS, they granted me permission to use the VS guidelines to teach others and encourage them to visit the CNS website. Vestibular schwannomas (VSs) lesions remain challenging. As outcomes remain imperfect, improvements in therapy are necessary. An important point is to use evidence-based techniques for future scientific and clinical research. The CNS objective was to study the best evidence-based management of VS, including initial audiologic evaluation, imaging diagnosis, use of surgical techniques, hearing preservation, and the administration of radiation therapy.

Methods: The Guideline Committee of the Joint Tumor Section of the CNS recruited experts from a multidisciplinary task force. Literature search strategy was undertaken. The inclusion/exclusion criteria to screen the citations for each of the questions were determined ahead of time for each section by the respective writing group. Evidence tables, reporting the extracted study information and evidence classification, were generated for the included studies for each of the questions.

Results: This guideline yielded some level 2 recommendations and a greater number of level 3 recommendations. In some case there was information that justified the recommendations.

The list of these recommendations can be reviewed at: https://www.cns.org/guidelines/guidelines-management-patients-vestibular-schwannoma.

Conclusion: This series of guidelines was constructed to assess the most current and clinically relevant evidence for the management of VS and future clinical research for which no recommendations could be formulated.