I am a 51yr old male recently diagnosed with a left acoustic neuroma

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I am a 51yr old male recently diagnosed with a left acoustic neuroma

Dear Dr. Sheehan....I am a 51yr old male recently 
diagnosed by MRI (11/16/2006)with a left Acoustic Neuroma 1.0cm 
x1.6cmx1.0cm located in the cp angle cistern. I have lost 70% of my 
hearing, as well as having moderate tennitius. I have been able to 
discuss treatment with Tomotherapy with a Radiation Oncologist. I 
also have consults scheduled with Neurosurgery and Neurotology. My 
primary physician was not able to discuss with me the advantages (or 
disadvantages) of each option. Given my tumor size, age and current 
hearing loss, is Gamma Knife the best long term option? any help in 
understanding my options is appreciated...Thanks Dave Bueby



Bueby,

Thank you for your question.  The standards of treatment for acoustic 
neuromas include surgical resection or stereotactic radiosurgery 
(i.e. using image guidance to give a high dose of radiation to the 
tumor with a steep fall off to surrounding tissues).  Long-term (>10 
year) follow-up results for both approaches have been published in 
peer reviewed journals.  Tomotherapy, although a promising technique, 
and one we utilize at the University of Virginia has not been well 
studied for acoustic neuromas nor has it been applied with any 
significant frequency for this indication.


At our center, Gamma Knife surgery, considered by most to be the gold 
standard for intracranial radiosurgery, offers a 98% chance of local 
tumor control, a less than 1% chance of facial palsy, and a 60% 
chance of hearing preservation.  The results from center to center 
vary and likely depend not just upon the radiosurgical device 
utilized but also upon the experience of treating team.  This is 
stated quite well on the bottom of the acoustic neuroma association 
(ANA) web page:  http://www.anausa.org/treatment_options.html 


Of note, the risk of secondary malignancy as a result of radiosurgery 
also appears substantially less than with fractionation schemes like 
tomotherapy or intensity modulation radiation therapy.


If you would like a more formal review of your case, please follow 
the instructions at the following link:
http://www.healthsystem.virginia.edularsleksell.cfm


Best wishes,
Jason Sheehan
<http://www.anausa.org/treatment_options.html>