Over the past years higher conformity and dose reduction decreased the risk for cranial nerve complications in radiosurgical treatment of vestibular schwannoma (VS). Nevertheless, the risk of additional hearing loss is still about 30 %. We studied the effect on hearing preservation by reducing of the maximum dose to 20 Gy while preserving a marginal dose of 13 Gy. 50 Patients with a follow up (FU) of at least 12 months (mean 21.3 months) were evaluated. The mean tumor volume was 1.9 ml. The tumor control rate was 94%. There were no complications of the brainstem. In two cases there was an increase in trigeminal dysaesthesia. One patient had transient facial nerve impairment. Functional hearing could be preserved in 93 % of the patients with functional hearing at the time of treatment.
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