Scientific publications

Clinical practice guideline on the management of vestibular schwannoma

Apr 1, 2024 | Magazine: Acta Otorrinolaringológica Española

Luis Lassaletta  1 , Leticia Acle Cervera  2 , Xabier Altuna  3 , Emilio Amilibia Cabeza  4 , Miguel Arístegui Ruiz  5 , Ángel Batuecas Caletrio  6 , Jesús Benítez Del Rosario  7 , Rubén Cabanillas Farpón  8 , María Costales Marcos  9 , Pedro Escada  10 , Juan Manuel Espinosa-Sánchez  11 , Roberto García Leal  12 , Javier Gavilán  13 , Justo Gómez Martínez  9 , Rocío González-Aguado  14 , Victor Martinez-Glez  15 , Gloria Guerra Jiménez  16 , Alejandro Harguindey Antolí-Candela  17 , Borja J Hernández García  18 , Cesar Orús Dotú  19 , Rubén Polo López  20 , Manuel Manrique  21 , Eduardo Martín Sanz  22 , Roberto Martínez Álvarez  23 , Henry Martínez  24 , Marta Martínez-Martínez  25 , Jorge Rey-Martinez  3 , Francisco Ropero Romero  26 , Santiago Santa Cruz Ruiz  6 , Luis Ángel Vallejo  27 , Andrés Soto Varela  28 , Isabel Varela-Nieto  29 , José Manuel Morales Puebla  30

Vestibular schwannoma (VS) is the most common tumour of the cerebellopontine angle. The greater accessibility to radiological tests has increased its diagnosis. Taking into account the characteristics of the tumour, the symptoms and the age of the patient, three therapeutic strategies have been proposed: observation, surgery or radiotherapy. Choosing the most appropriate for each patient is a frequent source of controversy.

Material and methods
This paper includes an exhaustive literature review of issues related to VS that can serve as a clinical guide in the management of patients with these lesions. The presentation has been oriented in the form of questions that the clinician usually asks himself and the answers have been written and/or reviewed by a panel of national and international experts consulted by the Otology Commission of the SEORL-CCC.

A list has been compiled containing the 13 most controversial thematic blocks on the management of VS in the form of 50 questions, and answers to all of them have been sought through a systematic literature review (articles published on PubMed and Cochrane Library between 1992 and 2023 related to each thematic area). Thirty-three experts, led by the Otology Committee of SEORL-CCC, have analyzed and discussed all the answers. In Annex 1, 14 additional questions divided into 4 thematic areas can be found.

This clinical practice guideline on the management of VS offers agreed answers to the most common questions that are asked about this tumour. The absence of sufficient prospective studies means that the levels of evidence on the subject are generally medium or low. This fact increases the interest of this type of clinical practice guidelines prepared by experts.

CITATION  Acta Otorrinolaringol Esp (Engl Ed). 2024 Mar-Apr;75(2):108-128. doi: 10.1016/j.otoeng.2023.10.005