The management of intracerebral tumours has always provided us with a challenge when deciding upon the best treatment approach. However, when such tumours are benign and located in close proximity to critical structures, tumour management becomes all the more challenging.

The treatment of vestibular schwannomas has always posed such problems because of their anatomical proximity to critical structures such as the brainstem and several cranial nerves. Through a comprehensive literature appraisal, this article evaluates the problems associated with conventional treatment options and discusses how technical advances over the past decades have affected disease management and therefore impacted on the range and type of treatment modalities employed. In addition, it highlights the role of alternative contemporary approaches in the management of vestibular schwannomas.