Surgery for vestibular schwannomas began in the 1890s, even before the advent of neurosurgery. It was SIR CHARLES BALLANCE who first successfully performed an operation on an acoustic neuroma on November 19, 1864. In 1917, Cushing recommended early diagnosis, and through meticulous clinical observations, he was able to establish the progression of symptoms from progressive unilateral hearing loss to intracranial hypertension. In 1941, Dandy published his findings on 41 cases of acoustic neuromas that had been surgically treated, reporting a 2.4% mortality rate following total excision, with the possibility of preserving the facial nerve in some cases after trepanating the posterior wall of the internal auditory canal. In 1962, House developed the translabyrinthine approach for the surgery of vestibular schwannomas. In 1997, Samii and Mathies published their series of 1,000 acoustic neuromas, all treated via the suboccipital transmeatal approach. Anatomical preservation of the facial nerve was 93%, and that of the cochlear nerve was 68%. Radiosurgery currently plays an essential role in the therapeutic arsenal for vestibular schwannomas.
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