My husband had surgical removal of 3.5 cm acoustic neuroma in Aug. '05 at Duke.

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My husband had surgical removal of 3.5 cm acoustic neuroma in Aug. '05 at Duke.

Question from Jennifer:

My husband had surgical removal of 3.5 cm acoustic neuroma in Aug. '05 at Duke. His surgeons left 2-3 mm of tumor on the facial nerve and a small plaque, perhaps 1 mm on the brain stem. The Duke surgeon has suggested follow up GK at U Va. Questions: 1. Would there be a greater risk of radiating healthy tissue by treating such a small amount of tumor residue? 2. Would it be better to wait and see if the tumor residue grows? 2. What is your GK accuracy, and has this been backed up with publication?

Dear Jennifer,

Your question is a good one. The fact that there is evidence of residual tumor is potentially problematic. If your husband's life expectancy is greater than 5 years, I would recommend earlier treatment of the residual tumor before it has a chance to grow. The Gamma Knife works best with small tumors. All residual acoustic neuromas will grow. Some demonstrate a step-wise fashion growth rate whereas others grow in a linear one fashion. The risk to benefit profile of the Gamma Knife favors earlier treatment of residual acoustic neuromas. Although there is a small chance of side effects in using the Gamma Knife to treat a residual/recurrent acoustic neuroma, there is a far greater chance of problems if nothing is done. The Gamma Knife has tremendous accuracy (typically less than 0.25 mm) and rapid dose fall-off to surrounding tissues. We perform quality assurance testing on our unit daily, weekly, and monthly. We have published extensively on our GK techniques and results. Some of these publications are listed on our web page.

Please feel free to contact my office at 434-924-8129 or 866-244-4040 (toll free) to arrange for a consultation for your husband.

--Jason Sheehan