# Vestibular schwannomas (review)

Source: https://onco.cc/key-papers/paper-carlson-link-vestibular-schwannomas-nejm-2021/  
OnCo record `paper-carlson-link-vestibular-schwannomas-nejm-2021` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A clinical review of acoustic neuromas covering how they present, why observation is now the first choice for most small tumours, and how microsurgery and radiosurgery compare for tumours that grow.

## Summary

Review article summarising the epidemiology, natural history, imaging, hearing outcomes and management of sporadic vestibular schwannoma, including the shift towards observation with serial MRI, indications and outcomes for stereotactic radiosurgery and microsurgery, quality-of-life considerations and NF2-related disease.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: New England Journal of Medicine
- Year: 2021
- DOI: 10.1056/NEJMra2020394
- Authors: Carlson ML, Link MJ.
- What it means: The observation-first approach and the framing of treatment as a trade between facial nerve function, hearing and tumour control on the vestibular schwannoma page reflect this review.
- Caveats: No randomised trials compare the three main strategies; recommendations rest on observational data.

## Sources

- N Engl J Med 2021: https://doi.org/10.1056/NEJMra2020394
- PubMed: https://pubmed.ncbi.nlm.nih.gov/33826821/

## Connected records

- cancers: [Vestibular schwannoma (acoustic neuroma)](https://onco.cc/cancers/vestibular-schwannoma/)
- journals: [New England Journal of Medicine](https://onco.cc/journals/nejm/)

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