Document Detail


Radiosurgery for acoustic neurinomas: early experience.
MedLine Citation:
PMID:  2191237     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We reviewed our early experience with the first 26 patients with acoustic neurinomas (21 unilateral, 5 bilateral) treated by stereotactic radiosurgery using the first North American 201-source cobalt-60 gamma knife. Follow-up ranged from 6 to 19 months (median, 13 months). Serial postoperative imaging showed either a decrease in tumor size (11 patients) or growth arrest (15 patients). Loss of central contrast enhancement was a characteristic change (18 patients). Seven patients had good or serviceable hearing preoperatively. In all 7 the preoperative hearing status was retained immediately after radiosurgery. At follow-up, 3 had preserved hearing, 1 had reduced hearing, and 3 had lost all hearing in the treated ear. Hearing in 1 patient that was nonserviceable preoperatively later improved to a serviceable hearing level. Delayed facial paresis developed in 6 patients, and delayed trigeminal sensory loss developed in 7 patients, none of whom had significant deficits before radiosurgery. Both facial and trigeminal deficits tended to improve within 3 to 6 months of onset with excellent recovery anticipated. Lower cranial nerve dysfunction was not observed. All 26 patients remain at their preoperative employment or functional status. At present, stereotactic radiosurgery is an alternative treatment for acoustic neurinomas in patients who are elderly, have significant concomitant medical problems, have a tumor in their only hearing ear, have bilateral acoustic neurinomas, refuse microsurgical excision, or have recurrent tumor despite surgical resection. Although longer and more extensive follow-up is required, the control of tumor growth and the acceptable rate of complications in this early experience testifies to the future expanding role of this technique in the management of selected acoustic neurinomas.
Authors:
M E Linskey; L D Lunsford; J C Flickinger
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  26     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  1990 May 
Date Detail:
Created Date:  1990-07-18     Completed Date:  1990-07-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  736-44; discussion 744-5     Citation Subset:  IM    
Affiliation:
Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pennsylvania.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Cobalt Radioisotopes / administration & dosage*
Female
Humans
Male
Microsurgery
Middle Aged
Neuroma, Acoustic / radiography,  radiotherapy*,  surgery
Stereotaxic Techniques*
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Cobalt Radioisotopes

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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