Postoperative imaging and follow-up of vestibular schwannomas

No standards exist regarding patient follow-up after complete vestibular schwannoma resection. We surveyed neurotologists and neurosurgeons to determine practice patterns. A nonrandomized sample of American Neurotology Society and North American Skull Base Society members was surveyed. Questions concerned years in practice, experience with vestibular schwannoma surgery, and postoperative follow-up algorithms given the scenario of complete gross tumor removal. Data were collected, tallied, and statistically analyzed. Academic and private practice neurotologists and neurosurgeons. Nonrandom sample of American Neurotology Society and North American Skull Base Society members. Number of postoperative magnetic resonance imaging scans, timing of magnetic resonance imaging scans, timing of final magnetic resonance imaging scan, timing of final visit, and variability between specialties. Four hundred ninety-eight surveys were sent and 135 were returned (27.1%). The average number of postoperative magnetic resonance imaging scans was 3.6 for neurotologists (range, 1-11) and 5.6 for neurosurgeons (range, 1-13). This was statistically significant (p >0.001). There was no correlation between number of magnetic resonance imaging scans and either years in practice or tumor experience. Average length of follow-up varied greatly (1 year to lifetime) but was most commonly 5 years. Eight percent of neurotologists varied their postoperative routine on the basis of surgical approach, whereas none of the neurosurgeons did. There remains no standard postoperative imaging algorithm for patients after complete vestibular schwannoma resection.