Postoperative imaging of vestibular schwannomas

Objectives: Assess the need for serial magnetic resonance imaging after vestibular schwannoma surgery. Study Design: Retrospective case review. Subjects and Methods: Study included all patients who underwent vestibular neuromas surgery over a five-year period from 1996 to 2000 at a single tertiary referral center. Analysis of tumor recurrence and correlation with enhancement types on postoperative imaging was performed. Results: During the five-year period, 359 cerebellopontine angle tumors were removed. The 299 patients had MRI imaging at one and five years for analysis and a five-year follow-up examination. Of these patients, 284 were found to have no enhancement at both one and five years. Linear enhancement was seen in ten patients but did not enlarge in any patient. Nodular enhancement of the internal auditory canal was observed in three patients. Two patients with nodular enhancement had tumor recurrence. Conclusions: Complete vestibular schwannoma resection has a low recurrence rate. Initial imaging should be performed at one year. Only patients with enhancement, subtotal resections, or neurofibromatosis type II need serial imaging.