REFERRAL PATTERNS IN VESTIBULAR SCHWANNOMAS

The investigation and treatment of vestibular schwannomas is an increa singly specialized area in which major advances have been seen over re cent years. The effect of these advances on the referral patterns to a centre specializing in such surgery is reviewed. The proportion of re ferrals with a known diagnosis has increased substantially, allowing t he specialist centre to focus on appropriate management rather than di agnosis. The vast majority of vestibular schwannomas are referred by o tolaryngologists. The caseload referred by neurologists or neurosurgeo ns have different presenting symptoms. The incidence of vestibular sch wannoma in the Cambridge district is found to be 1 per 50 000 populati on per year. This is a higher incidence than that recorded in other st udies. This may be due to a tight diagnostic strategy and the high lev el of clinical awareness of the local general practitioners.