Stereotactic Radiosurgery for Acoustic Neuroma

Specialists at NYU Langone may use stereotactic radiosurgery to stop the growth of an acoustic neuroma, also called vestibular schwannoma. This treatment uses energy beams, or radiation, to destroy tumor cells. It does not remove an acoustic neuroma but inactivates it.

Usually, the tumor shrinks over time, often years after treatment has been completed. Another approach called fractionated stereotactic radiotherapy may be used if radiosurgery is not an option.

Stereotactic Radiosurgery

Doctors use stereotactic radiosurgery, or Gamma Knife® surgery, to treat smaller acoustic neuromas. It may also be used when conventional surgery is not possible due to poor health or advanced age. Despite the name, a Gamma Knife® is not a knife or a scalpel but rather a system for delivering targeted, accurate, and precise radiation.

With Gamma Knife® surgery, doctors can deliver radiation to acoustic neuromas in the narrow confines of the internal auditory canal, while avoiding or minimizing damage to important nerves—those responsible for hearing, balance, and facial movement and sensation. The major goals of Gamma Knife® surgery are to preserve cranial nerve function and avoid the risks of open surgery. For example, this approach may be less likely to damage hearing or facial function than surgery.

Working together, our neurosurgeons and radiation oncologists use highly detailed MRI and CT studies to create a customized and precise treatment plan for the acoustic neuroma. Then, using the Gamma Knife® system, highly targeted radiation beams are directed to the tumor in one treatment session. Critical neighboring structures receive only a low dose of radiation.

Because Gamma Knife® surgery depends on the precise delivery of radiation beams, people being treated wear a head frame during the procedure, which prevents them from moving and allows for precise targeting of the treatment.

Dr. Douglas Kondziolka Fits Patient with Head Brace

Dr. Douglas Kondziolka fits a patient with a head brace prior to treatment.

Gamma Knife® surgery is an outpatient procedure and usually takes a few hours to complete.

Fractionated Stereotactic Radiotherapy

Fractionated stereotactic radiotherapy may be used in people who can’t have surgery due to poor health or who have tumors too large to be managed with Gamma Knife® surgery. This approach uses MRI or CT imaging results and treatment planning software to deliver highly targeted radiation therapy. Doctors give fractionated stereotactic radiotherapy in low daily doses over several weeks to treat the tumor.

Managing Side Effects

NYU Langone physicians monitor you for side effects such as dizziness, headache, and further hearing problems. They offer medications, integrative therapies—including acupuncture and massage therapy—and rehabilitation services to manage these side effects.

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