Consensus guidelines for the management of vestibular schwannoma for lowand middle-income countries

Abstract

Vestibular Schwannoma (VS), previously known as
acoustic neuroma, constitutes the majority of tumours
found in the cerebellopontine angle (CPA). Most
guidelines for managing CPA tumours have been
developed by high-income countries (HICs). However,
these guidelines often fall short in addressing the unique
challenges encountered in low- and middle-income
countries (LMICs), such as Pakistan. In LMICs, issues
related to a limited healthcare workforce, inadequate
infrastructure, and constrained financial resources hinder
the effective implementation of these HIC-derived
guidelines. Additionally, it has been observed that VS
tends to present at a larger size in LMICs compared to
HICs. Given that VS is the predominant type of CPA
tumour and other types are covered under separate
guidelines, this article aims to provide practical, contextspecific
recommendations for the screening, diagnosis,
and management of Vestibular Schwannoma in LMIC
settings. Our focus is to bridge the gap in care strategies
and adapt them to the resource constraints and clinical
realities of LMICs.
Keywords: Neuroma, acoustic, cerebellopontine angle,
health care, vestibular schwannoma, radiosurgery,
tumours