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Real-world vestibular schwannoma management: treatment trends, facial weakness and disparities in a large US network analysis
Published online by Cambridge University Press: 06 November 2025
Abstract
Objectives
To characterize treatment trends and facial weakness outcomes in vestibular schwannoma management using real-world data from a large US patient cohort.
Methods
This retrospective cohort analysis utilized the TriNetX US Collaborative Network. The study included 72,496 patients diagnosed with vestibular schwannoma, managed with observation, stereotactic radiosurgery or surgical treatments. Main outcome measures were demographic profiles, treatment modality utilization, facial weakness incidence and historical (2022–2025) and predicted (2025–2026) treatment trends.
Results
It showed a slight female predominance (54.35 per cent) and underrepresentation of Black and Asian patients. Observation was most common (87.6 per cent), followed by surgery (65.3 per cent) and stereotactic radiosurgery (34.7 per cent). Facial weakness rates: 4.7 per cent (observation), 9.1 per cent (stereotactic radiosurgery), 24.4 per cent (surgery). Combined treatments had higher facial weakness rates. Stereotactic radiosurgery use was stable; translabyrinthine surgery declined; posterior fossa approaches increased.
Conclusion
This comprehensive analysis highlights varying facial weakness risks across treatment modalities, disparities in the treatments and evolving treatment preferences.
Information
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- Copyright
- © The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.
Footnotes
Huseyin Isildak takes responsibility for the integrity of the content of the paper
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