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Open research questions in Meningioma and schwannoma management

284 gap statements mined from Meningioma and schwannoma management papers in our 7.9M-paper local library, which holds 1,079 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.

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What the literature leaves open

  • Further studies are needed to investigate the relationship between MRE and perfusion MRI in larger cohorts. Research should focus on developing more widely available and accessible imaging protocols for MRE. Investigations into the biological mechanisms underlying the differences in MRE-derived stiffness and perfusion MRI measurements are necessary.

    MR elastography and perfusion MRI characterize distinct biomechanical and vascular features of meningiomas · 2026 · DOI

  • The relationship between MRE and perfusion MRI in characterizing meningioma biology is uncertain. There is a need to evaluate regional MRE and perfusion MRI measurements in meningiomas. The study aims to address this gap by evaluating regional MRE and perfusion MRI measurements in a cohort of 55 histopathologically confirmed meningiomas.

    MR elastography and perfusion MRI characterize distinct biomechanical and vascular features of meningiomas · 2026 · DOI

  • The relative contributions of tumor burden and surgical management to overall survival in elderly and very elderly patients remain incompletely characterized at a population level in VS patients.

    Management Patterns and Outcomes of Vestibular Schwannoma in Older Adults: Assessment of the SEER Database · 2026 · DOI

  • Stereotactic radiosurgery (SRS) provides excellent tumor control in small and medium vestibular schwannomas (VS), but its impact on the vestibular system remains uncertain.

    Vestibular dose predicts toxicity in stereotactic radiosurgery for vestibular schwannomas · 2026 · DOI

  • Further prospective studies with a predefined target volume are warranted to validate our findings.

    Wide dural radiation therapy for NF2-SWN associated meningiomatosis · 2026 · DOI

  • Molecular classifications of meningiomas improve biological and prognostic stratification, but their complexity can hinder routine implementation, and their treatment implications remain unclear.

    Prognostic associations of surgical resection and adjuvant radiotherapy in meningioma defined by an exome–sequencing–based grading · 2026 · DOI

  • Prior studies have reported favorable local control for patients with vestibular schwannomas (VS) treated with Gamma Knife radiosurgery (GKRS) or linear accelerator (LINAC)-based radiosurgery; however, direct comparisons of quality-of-life outcomes with each approach are lacking.

    Outcomes for Patients With Vestibular Schwannomas Treated With Gamma Knife Versus Linear Accelerator–Based Radiosurgery: A Retrospective Review · 2026 · DOI

  • Limited evidence guides the optimal timing of treatment after the detection of tumor growth during the observation of sporadic vestibular schwannoma (VS).

    Optimal Timing of Primary Radiosurgical Treatment of Growing Vestibular Schwannoma: Insights From Salvage Microsurgery Outcomes · 2025 · DOI

  • Their histological grading according to CNS WHO criteria alone provides limited information on recurrence risk.

    Testing Meningiomas With Methylation Arrays: Insights and Recommendations From a Large Single‐Centre Study · 2025 · DOI

  • A small proportion of Grade 1 meningiomas may also benefit from integrated molecular analysis, and further research is needed to explore if those histologically benign meningiomas with a predicted increased recurrence risk are associated with distinct demographic or histological characteristics.

    Testing Meningiomas With Methylation Arrays: Insights and Recommendations From a Large Single‐Centre Study · 2025 · DOI

  • While adjuvant radiation therapy (RT) may prolong progression-free survival in resected atypical meningiomas, whether such progression-free survival benefit outweighs potential treatment toxicities remains controversial.

    Toxicities Associated with Adjuvant Radiation Therapy in Atypical Meningioma · 2025 · DOI

  • However, the factors influencing tumour recurrence and progression after surgery remain unclear.

    PD‐L1 expression pattern as predictive factor of biological behaviour in intracranial meningiomas: A single‐center retrospective study · 2025 · DOI

  • However, reports in the literature on the use of this technique to treat intradural spinal tumors remain scarce.

    Full-Endoscopic Resection of a Lumbar Intradural Tumor (Schwannoma): Video Case Report and Description of the Surgical Technique · 2024 · DOI

  • Future work should prioritize multicenter, prospective cohorts with standardized reporting of clinical, dosimetric, and surgical variables. Harmonized definitions of local control, prospectively collected late toxicity graded with contemporary systems (e.g., CTCAE), and routine reporting of grade ≥ 3 events would substantially reduce measurement bias and strengthen future meta-analytic inferences.

    Effectiveness and safety of proton therapy in intracranial meningioma treatment: a systematic review and meta-analysis · 2026 · DOI

  • The lack of systematic evaluation of complication rates associated with the endoscopic transorbital approach. The need for a comprehensive review of the current literature on this approach.

    Safety profile and surgical outcomes of the endoscopic transorbital approach as a skull base surgical corridor: a systematic review and meta-analysis · 2026 · DOI

  • The study has a limited sample size. The dataset is retrospective. The performance estimates should be interpreted cautiously due to the limited size of the held-out test set.

    Feasibility of Deep Learning-Based Segmentation of the Facial and Vestibulocochlear Nerves on High-Resolution Magnetic Resonance Imaging · 2026 · DOI

  • Lastly, the long-term impact of a titanium cranioplasty on cranial growth and remodelling in a 9-year-old patient remains unknown and warrants longitudinal monitoring.

    Primary intraosseous meningioma in a child: an unusual case report and literature review · 2026 · DOI

  • Future research should focus on molecular and genetic investigation of PIOMs, particularly in pediatric cases, to identify potential therapeutic targets. Multicenter studies are needed to compile larger cohorts of pediatric PIOMs, given the rarity of PIOMs in order to improve their management.

    Primary intraosseous meningioma in a child: an unusual case report and literature review · 2026 · DOI

  • The study excluded participants who had multiple meningiomas. The study had a limited number of participants (37).

    Multimodal brain MRI and clinical data in olfactory groove meningioma: a prospective data report · 2026 · DOI

  • The need to develop new diagnostic and treatment strategies for patients with unilateral vestibular schwannoma.

    Oculomotor and Caloric Test Findings in 122 Patients With Unilateral Vestibular Schwannoma · 2026 · DOI

  • The study had a limited number of studies that met the inclusion criteria. The study used a systematic literature review, which may be subject to bias. The anatomical dissections were conducted on a limited number of specimens.

    What is the best surgical approach for Pineal Region Tumors? A systematic literature review and anatomical comparative study · 2026 · DOI

  • There is no consensus on the optimal surgical approach for pineal region tumors. The study aims to address this gap by evaluating surgical approaches and comparing their complication profiles.

    What is the best surgical approach for Pineal Region Tumors? A systematic literature review and anatomical comparative study · 2026 · DOI

  • Third, while it provides objective geometric data, the clinical interpretation of these metrics—particularly in terms of patient-reported function or psychosocial impact—remains to be fully validated. Second, Emotrics currently does not account for dynamic facial movements such as speech or spontaneous expression, which may limit its sensitivity to certain functional deficits.

    Quantitative facial analysis using emotrics in patients undergoing vestibular schwannoma surgery · 2026 · DOI

  • To examine the long-term effects of unilateral vestibular schwannoma on oculomotor and caloric test findings. To compare the test metrics between different types of vestibular disorders.

    Oculomotor and Caloric Test Findings in 122 Patients With Unilateral Vestibular Schwannoma · 2026 · DOI

  • The lack of systematic evaluation of IAC morphology in patients with intralabyrinthine schwannomas, - the potential for diagnostic ambiguity and overattribution of vestibular manifestations, - the need for adjunctive bedside assessments such as the hyperventilation…

    Comment on Chen et al. Vestibulo-Ocular Reflex Results in Patients with Intralabyrinthine Schwannomas: Case Series with a Literature Review. Diagnostics 2025, 15, 2093 · 2026 · DOI

Most-cited papers in Meningioma and schwannoma management

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Open questions raised by papers listed on this page include: (1) Further studies are needed to investigate the relationship between MRE and perfusion MRI in larger cohorts (“MR elastography and perfusion MRI characterize distinct biomechanical and…”, 2026); (2) The relative contributions of tumor burden and surgical management to overall survival in elderly and very elderly patients remain incompletely characterized at a population level in VS patients (“Management Patterns and Outcomes of Vestibular Schwannoma in Older Adults:…”, 2026); (3) Molecular classifications of meningiomas improve biological and prognostic stratification, but their complexity can hinder routine implementation, and their treatment implications remain unclear (“Prognostic associations of surgical resection and adjuvant radiotherapy in…”, 2026); (4) Future work should prioritize multicenter, prospective cohorts with standardized reporting of clinical, dosimetric, and surgical variables (“Effectiveness and safety of proton therapy in intracranial meningioma…”, 2026); (5) The lack of systematic evaluation of complication rates associated with the endoscopic transorbital approach (“Safety profile and surgical outcomes of the endoscopic transorbital approach as…”, 2026). 284 gap statements have been mined from Meningioma and schwannoma management papers in our 7.9M-paper local library, which holds 1,079 papers on the topic; the gaps come from whichever of those papers state one. They are mostly the research gaps the authors state and the papers' abstracts, plus future-work, limitations and challenges passages. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one, so you can read the original claim in context.

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