Acoustic tumors: operation versus radiation--making sense of opposing viewpoints. Part II. Acoustic neuromas: sorting out management options.

Patients with acoustic neuromas have several options available to them. Large tumors with significant brain stem compression usually require surgical resection. For patients with small or medium-sized tumors, radiosurgery has become a common treatment, with excellent long-term results being reported. Patients must be comfortable with the concept of tumor control rather than tumor removal. Most seem to be satisfied with this concept if it allows them to avoid brain surgery. Surgeons should strive to educate their patients with information from the peer-reviewed literature. Confusion exists among patients, because the information from Internet sources, newsletters, support groups, and physicians has not always been validated and supported by outcomes data. Although we are asked to provide our opinions, our comments should not be based on myth, conjecture, training bias, or socioeconomic concerns.