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Vestibular Schwannoma
Surjith Vattoth, MD, FRCR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Vestibular schwannoma (VS)
              • Synonyms

                • Misnomers: Acoustic schwannoma, acoustic neuroma, acoustic tumor
                  • Uncommon names: Neurinoma, neurilemmoma
              • Definitions

                • Benign tumor arising from Schwann cells that wrap vestibular branches of CNVIII in cerebellopontine angle-internal auditory canal (CPA-IAC)

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            • Reporting Tips

                                              Selected References

                                              1. Basu S et al: Screening for vestibular schwannoma in the context of an ageing population. J Laryngol Otol. 133(8):640-9, 2019
                                              2. Constanzo F et al: Cerebellopontine angle schwannomas arising from the intermediate nerve: a scoping review. Neurosurg Rev. ePub, 2019
                                              3. Shapey J et al: Clinical applications for diffusion MRI and tractography of cranial nerves within the posterior fossa: a systematic review. Front Neurosci. 13:23, 2019
                                              4. Thompson NJ et al: Translabyrinthine excision of vestibular schwannoma with concurrent cochlear implantation: systematic review. J Neurol Surg B Skull Base. 80(2):187-95, 2019
                                              5. Germano IM et al: Congress of Neurological Surgeons systematic review and evidence-based guidelines on the role of radiosurgery and radiation therapy in the management of patients with vestibular schwannomas. Neurosurgery. 82(2):E49-51, 2018
                                              6. Oh JH et al: Clinical application of 3D-FIESTA image in patients with unilateral inner ear symptom. Korean J Audiol. 17(3):111-7, 2013
                                              7. Tomogane Y et al: Usefulness of PRESTO magnetic resonance imaging for the differentiation of schwannoma and meningioma in the cerebellopontine angle. Neurol Med Chir (Tokyo). 53(7):482-9, 2013
                                              8. Roosli C et al: What is the site of origin of cochleovestibular schwannomas? Audiol Neurootol. 17(2):121-5, 2012
                                              9. Tryggvason G et al: Radiographic association of schwannomas with sensory ganglia. Otol Neurotol. 33(7):1276-82, 2012
                                              10. Bakkouri WE et al: Conservative management of 386 cases of unilateral vestibular schwannoma: tumor growth and consequences for treatment. J Neurosurg. 110(4):662-9, 2009
                                              11. Fortnum H et al: The role of magnetic resonance imaging in the identification of suspected acoustic neuroma: a systematic review of clinical and cost effectiveness and natural history. Health Technol Assess. 13(18):iii-iv, ix-xi, 1-154, 2009
                                              12. Fukuoka S et al: Gamma knife radiosurgery for vestibular schwannomas. Prog Neurol Surg. 22:45-62, 2009
                                              13. Bhadelia RA et al: Increased cochlear fluid-attenuated inversion recovery signal in patients with vestibular schwannoma. AJNR Am J Neuroradiol. 29(4):720-3, 2008
                                              14. Ferri GG et al: Conservative management of vestibular schwannomas: an effective strategy. Laryngoscope. 118(6):951-7, 2008
                                              15. House JW et al: False-positive magnetic resonance imaging in the diagnosis of vestibular schwannoma. Otol Neurotol. 29(8):1176-8, 2008
                                              16. Meijer OW et al: Tumor-volume changes after radiosurgery for vestibular schwannoma: implications for follow-up MR imaging protocol. AJNR Am J Neuroradiol. 29(5):906-10, 2008
                                              17. Thamburaj K et al: Intratumoral microhemorrhages on T2*-weighted gradient-echo imaging helps differentiate vestibular schwannoma from meningioma. AJNR Am J Neuroradiol. 29(3):552-7, 2008
                                              18. Jacob A et al: Nerve of origin, tumor size, hearing preservation, and facial nerve outcomes in 359 vestibular schwannoma resections at a tertiary care academic center. Laryngoscope. 117(12):2087-92, 2007
                                              19. Maire JP et al: Twenty years' experience in the treatment of acoustic neuromas with fractionated radiotherapy: a review of 45 cases. Int J Radiat Oncol Biol Phys. 66(1):170-8, 2006
                                              20. Okamoto K et al: Focal T2 hyperintensity in the dorsal brain stem in patients with vestibular schwannoma. AJNR Am J Neuroradiol. 27(6):1307-11, 2006
                                              21. Furuta S et al: Prediction of the origin of intracanalicular neoplasms with high-resolution MR imaging. Neuroradiology. 47(9):657-63, 2005
                                              22. Lin D et al: The prevalence of "incidental" acoustic neuroma. Arch Otolaryngol Head Neck Surg. 131(3):241-4, 2005
                                              23. Myrseth E et al: Vestibular schwannomas: clinical results and quality of life after microsurgery or gamma knife radiosurgery. Neurosurgery. 56(5):927-35; discussion 927-35, 2005
                                              24. Darrouzet V et al: Vestibular schwannoma surgery outcomes: our multidisciplinary experience in 400 cases over 17 years. Laryngoscope. 114(4):681-8, 2004
                                              25. Kobayashi M et al: Distance from acoustic neuroma to fundus and a postoperative facial palsy. Laryngoscope. 112(1):168-71, 2002
                                              26. Dubrulle F et al: Cochlear fossa enhancement at MR evaluation of vestibular schwannoma: correlation with success at hearing-preservation surgery. Radiology. 215(2):458-62, 2000
                                              27. Gillespie JE: MRI screening for acoustic neuroma. Br J Radiol. 73(874):1129-30, 2000
                                              28. Nakamura H et al: Serial follow-up MR imaging after gamma knife radiosurgery for vestibular schwannoma. AJNR Am J Neuroradiol. 21(8):1540-6, 2000
                                              29. Zealley IA et al: MRI screening for acoustic neuroma: a comparison of fast spin echo and contrast enhanced imaging in 1233 patients. Br J Radiol. 73(867):242-7, 2000
                                              30. Allen RW et al: Low-cost high-resolution fast spin-echo MR of acoustic schwannoma: an alternative to enhanced conventional spin-echo MR? AJNR Am J Neuroradiol. 17(7):1205-10, 1996
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Abbreviations

                                                            • Vestibular schwannoma (VS)
                                                          • Synonyms

                                                            • Misnomers: Acoustic schwannoma, acoustic neuroma, acoustic tumor
                                                              • Uncommon names: Neurinoma, neurilemmoma
                                                          • Definitions

                                                            • Benign tumor arising from Schwann cells that wrap vestibular branches of CNVIII in cerebellopontine angle-internal auditory canal (CPA-IAC)

                                                          IMAGING

                                                          • General Features

                                                            • CT Findings

                                                              • MR Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Staging, Grading, & Classification

                                                                        • Gross Pathologic & Surgical Features

                                                                          • Microscopic Features

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    DIAGNOSTIC CHECKLIST

                                                                                    • Consider

                                                                                      • Image Interpretation Pearls

                                                                                        • Reporting Tips

                                                                                          Selected References

                                                                                          1. Basu S et al: Screening for vestibular schwannoma in the context of an ageing population. J Laryngol Otol. 133(8):640-9, 2019
                                                                                          2. Constanzo F et al: Cerebellopontine angle schwannomas arising from the intermediate nerve: a scoping review. Neurosurg Rev. ePub, 2019
                                                                                          3. Shapey J et al: Clinical applications for diffusion MRI and tractography of cranial nerves within the posterior fossa: a systematic review. Front Neurosci. 13:23, 2019
                                                                                          4. Thompson NJ et al: Translabyrinthine excision of vestibular schwannoma with concurrent cochlear implantation: systematic review. J Neurol Surg B Skull Base. 80(2):187-95, 2019
                                                                                          5. Germano IM et al: Congress of Neurological Surgeons systematic review and evidence-based guidelines on the role of radiosurgery and radiation therapy in the management of patients with vestibular schwannomas. Neurosurgery. 82(2):E49-51, 2018
                                                                                          6. Oh JH et al: Clinical application of 3D-FIESTA image in patients with unilateral inner ear symptom. Korean J Audiol. 17(3):111-7, 2013
                                                                                          7. Tomogane Y et al: Usefulness of PRESTO magnetic resonance imaging for the differentiation of schwannoma and meningioma in the cerebellopontine angle. Neurol Med Chir (Tokyo). 53(7):482-9, 2013
                                                                                          8. Roosli C et al: What is the site of origin of cochleovestibular schwannomas? Audiol Neurootol. 17(2):121-5, 2012
                                                                                          9. Tryggvason G et al: Radiographic association of schwannomas with sensory ganglia. Otol Neurotol. 33(7):1276-82, 2012
                                                                                          10. Bakkouri WE et al: Conservative management of 386 cases of unilateral vestibular schwannoma: tumor growth and consequences for treatment. J Neurosurg. 110(4):662-9, 2009
                                                                                          11. Fortnum H et al: The role of magnetic resonance imaging in the identification of suspected acoustic neuroma: a systematic review of clinical and cost effectiveness and natural history. Health Technol Assess. 13(18):iii-iv, ix-xi, 1-154, 2009
                                                                                          12. Fukuoka S et al: Gamma knife radiosurgery for vestibular schwannomas. Prog Neurol Surg. 22:45-62, 2009
                                                                                          13. Bhadelia RA et al: Increased cochlear fluid-attenuated inversion recovery signal in patients with vestibular schwannoma. AJNR Am J Neuroradiol. 29(4):720-3, 2008
                                                                                          14. Ferri GG et al: Conservative management of vestibular schwannomas: an effective strategy. Laryngoscope. 118(6):951-7, 2008
                                                                                          15. House JW et al: False-positive magnetic resonance imaging in the diagnosis of vestibular schwannoma. Otol Neurotol. 29(8):1176-8, 2008
                                                                                          16. Meijer OW et al: Tumor-volume changes after radiosurgery for vestibular schwannoma: implications for follow-up MR imaging protocol. AJNR Am J Neuroradiol. 29(5):906-10, 2008
                                                                                          17. Thamburaj K et al: Intratumoral microhemorrhages on T2*-weighted gradient-echo imaging helps differentiate vestibular schwannoma from meningioma. AJNR Am J Neuroradiol. 29(3):552-7, 2008
                                                                                          18. Jacob A et al: Nerve of origin, tumor size, hearing preservation, and facial nerve outcomes in 359 vestibular schwannoma resections at a tertiary care academic center. Laryngoscope. 117(12):2087-92, 2007
                                                                                          19. Maire JP et al: Twenty years' experience in the treatment of acoustic neuromas with fractionated radiotherapy: a review of 45 cases. Int J Radiat Oncol Biol Phys. 66(1):170-8, 2006
                                                                                          20. Okamoto K et al: Focal T2 hyperintensity in the dorsal brain stem in patients with vestibular schwannoma. AJNR Am J Neuroradiol. 27(6):1307-11, 2006
                                                                                          21. Furuta S et al: Prediction of the origin of intracanalicular neoplasms with high-resolution MR imaging. Neuroradiology. 47(9):657-63, 2005
                                                                                          22. Lin D et al: The prevalence of "incidental" acoustic neuroma. Arch Otolaryngol Head Neck Surg. 131(3):241-4, 2005
                                                                                          23. Myrseth E et al: Vestibular schwannomas: clinical results and quality of life after microsurgery or gamma knife radiosurgery. Neurosurgery. 56(5):927-35; discussion 927-35, 2005
                                                                                          24. Darrouzet V et al: Vestibular schwannoma surgery outcomes: our multidisciplinary experience in 400 cases over 17 years. Laryngoscope. 114(4):681-8, 2004
                                                                                          25. Kobayashi M et al: Distance from acoustic neuroma to fundus and a postoperative facial palsy. Laryngoscope. 112(1):168-71, 2002
                                                                                          26. Dubrulle F et al: Cochlear fossa enhancement at MR evaluation of vestibular schwannoma: correlation with success at hearing-preservation surgery. Radiology. 215(2):458-62, 2000
                                                                                          27. Gillespie JE: MRI screening for acoustic neuroma. Br J Radiol. 73(874):1129-30, 2000
                                                                                          28. Nakamura H et al: Serial follow-up MR imaging after gamma knife radiosurgery for vestibular schwannoma. AJNR Am J Neuroradiol. 21(8):1540-6, 2000
                                                                                          29. Zealley IA et al: MRI screening for acoustic neuroma: a comparison of fast spin echo and contrast enhanced imaging in 1233 patients. Br J Radiol. 73(867):242-7, 2000
                                                                                          30. Allen RW et al: Low-cost high-resolution fast spin-echo MR of acoustic schwannoma: an alternative to enhanced conventional spin-echo MR? AJNR Am J Neuroradiol. 17(7):1205-10, 1996