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.