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To the Editor: The summary report of the Consensus Development Conference on Vestibular Schwannoma (Acoustic Neuroma) (1) does not do justice to the radiation therapy option. The panel is correct in its emphasis on skilled and specialized multidisciplinary management, as applied to the surgery of these difficult tumors, because, in general, the morbidity rate after surgical treatment remains high, with over 90% of patients suffering hearing loss and over 60% some permanent facial weakness. Stereotactic radiosurgery has now been used at the Karolinska Institute, Stockholm, Sweden, since 1969. The results of the treatment of 126 patients were reported by Hirsch and Norén in 1988 (3). The average follow-up was 4.5 years. Tumors were controlled in 86% of the cases. Hearing was preserved in 27%, and there was no permanent facial paresis. From more recent unpublished data, the control rates are now over 90%, and in the last consecutively treated 100 patients, there have been no cases of even transient facial weakness.

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