What treatment technique do you recommend for maximum hearing preservation when treating a vestibular schwannoma: fractionated radiosurgery (25 Gy in 5 fractions) or single fraction radiosurgery?

HI I was asked to respond to this very interesting question, we have tried both 5Gyx5 and SRS for these cases, and we moved our practice from SRS to hypofractionated a number of years ago. I have been equally disappointed with the outcomes in terms of hearing preservation with both approaches, particularly in longer term follow up, so we have moved back to radiosurgery for appropriate lesions because it is more convenient for patients and hearing preservation rate is no worse...