Radiosurgery of acoustic neurinomas

Article Abstract:

Carefully guided intense beams of gamma rays can be used to destroy living tissues. While not suitable for the majority of surgical procedures, this so-called 'gamma-knife' can be quite effective when a small, clearly defined area of tissue needs to be destroyed and invasive surgery is either undesirable or impossible. One such case is the acoustic neurinoma. These tumors, which involve the eight cranial nerve, are histologically benign (not cancerous), but they are far from harmless. As they grow on the acoustic nerve, they eventually cause deafness, and may ultimately grow to a point where they begin to compress the brainstem. Conventional surgery does not prevent deafness in 94 percent of affected ears. In addition, conventional surgery in this delicate area is difficult; 5.7 percent of the patients develop meningitis and 7.2 percent develop spinal fluid leaks. Over 6 percent will require the implantation of a shunt to drain off cerebrospinal fluid. The authors have evaluated the use of the gamma knife in the treatment of acoustic neurinoma in 85 patients. After two years, 46 percent of the patients retained useful hearing, and none of the complications associated with conventional surgery were seen in these patients. Follow-up at one year indicated that the acoustic neurinomas had shrunk in 55 percent of the patients and had remained the same size another 43 percent. In only one patient did the size of the neurinoma increase after gamma radiosurgery. The authors suggest that gamma radiosurgery is becoming an important alternative treatment for patients with acoustic neurinoma. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Radiotherapy

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Treatment of acoustic neuromas

Article Abstract:

In an article discussing the treatment of acoustic neuroma, a disorder also known as vestibular schwannoma, the use of radiosurgery was lauded, but certain questions are raised. Acoustic neuroma is a benign tumor in the ear which can press on neural tissue and cause damage. The process seems an improvement over other techniques, most of which have a high number of complications such as facial weakness or numbness. However, the technique used changed several times during the course of the study, as did the levels of radiation used, and a large number of patients were lost during the follow-up.

Editorial

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Long-term outcomes after radiosurgery for acoustic neuromas

Article Abstract:

The use of radiosurgery to treat acoustic neuromas seems to be effective as a control of those tumors on a long-term basis. Acoustic neuromas, also called vestibular schwannomas, are benign individual encapsulated tumors which can impinge on neural paths and interfere with nerve function. Evaluating 162 patients over a period of five to ten years, the rate of tumor control was found to be 98% with no resection involved. Facial and auditory functions were preserved in a large majority of the patients.

Health aspects

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