Advancing the Management of Vestibular Schwannoma: Innovations, Challenges, and Future Perspectives in Multidisciplinary Care

Due to increased MRI accessibility, vestibular schwannoma (VS), sometimes referred to as acoustic neuroma, is now more frequently detected. VS is a benign tumor that arises from the Schwann cells of the vestibulocochlear nerve and primarily affects older adults. This study provides a detailed overview of the natural history, epidemiology, molecular pathology, diagnostic developments, and evolving management approaches of VS. Because of the varied growth patterns of VS, some tumors remain stable while others grow rapidly, necessitating individualized treatment strategies. To optimize outcomes, multidisciplinary care, integrating radiology, otolaryngology, neurosurgery, and radiation oncology, has become essential in VS management. Advances in molecular biology have identified key genetic abnormalities, signalling pathways, and biomarkers associated with tumor growth and hearing loss, enabling the development of targeted therapies such as bevacizumab. Diagnostic methods, including MRI and audiovestibular testing, play a crucial role in guiding clinical decision-making alongside patient-centred counselling. Innovations in endoscopic and microsurgical techniques have reduced surgical morbidity and improved facial nerve preservation. Systemic treatments such as stereotactic radiosurgery offer effective, less invasive alternatives. Ongoing clinical trials are exploring gene therapy, neuroprotective strategies, pharmacologic treatments, and quality-of-life improvements. Despite significant progress, challenges persist, including global healthcare disparities, complications management, and limitations in early diagnosis. Future directions emphasize collaborative research, technological integration, and personalized treatment approaches to further enhance VS care.