ANA Discussion Forum
Treatment Options => Microsurgical Options => Topic started by: annamaria on October 22, 2010, 04:35:25 am
-
HNO. 2010 Oct 22. [Epub ahead of print]
[Acoustic neuroma (vestibular schwannoma) : Treatment from a neurosurgical perspective.]
Schick U, Unterberg A.
Neurochirurgische Universitätsklinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland, uta.schick@med.uni-heidelberg.de.
Abstract
During the last century microsurgical approaches laid emphasis in descending order on preservation of life, total tumor excision and function. Today, the priority of microsurgery has changed to functional preservation. The management of vestibular schwannomas consists of observation, surgical resection, or radiation therapy. In recent years, there has been an increase in observation-only management for small tumors, or radiotherapy in the case of tumor progression.
The number of surgical procedures is in decline, with surgery being reserved mainly for large tumors.
- - - - - -
Annamaria
-
The number of surgical procedures is in decline, with surgery being reserved mainly for large tumors.
Interesting. Judging by the number of people who post on this Forum it seems like the number of surgical procedures are about equal to the number of radiation procedures.
That might just be my perception though.
As one who chose surgery I've been very happy with my outcome and have never regretted "going under the knife" and my tumor wasn't really that large (approximately 3 cms).
I think it all boils down to personal choice. What's good for one isn't necessarily good for all.
Thanks for posting this, Annamaria.
Jan
-
Btw, the quote "The number of surgical procedures is in decline..." is directly from the paper and not my interpretation ...
Annamaria
-
Interesting, thank you for sharing. I wonder if this is just a function of advances in technology?
Liz
-
I was treated in Germany for my AN and was told that a majority of AN's are now treated by either Cyberknife or Gammaknife.
I think I was told around 80% of AN's smaller than 3cm are treated by radiosurgery in Germany but please don't quote me on that.
Do you have a link?
I would certainly like to confirm those figures.
The radiosurgery community in Germany has very strong roots with the inventor of the Gammaknife Lars Leksell, and was one of the first countries to embrace radiosurgery.
John Adler from Stanford, inventor of the Cyberknife spent 1 year in Sweden training under Lars Leksell.
Given the history of radiosurgery there is a lot of experience and knowledge available in Europe for radiosurgical treatment of AN.
Its a pity due to language and different medical protocols that we dont see more published studies from Europe on AN's
Certainly some opportunity for the AN community to look at what is happenning in different countries and compare outcomes.
-
For the link go to
http://www.ncbi.nlm.nih.gov/sites/entrez
and type in "acoustic neuroma"
[Probably one world have to purchase the full article for the details -- I have purchased a bunch of them, but I'm not planning to download this one]
Annamaria
-
Thank you, Annamaria, for posting this interesting excerpt. When I was doing my intensive personal research on ANs a few years ago, I ran across a medical study that came to the same conclusion about the relative decline of surgery for treating ANs.
In yet another study, a group of neurosurgeons were asked which form of treatment they would choose if they were diagnosed with an AN that was small enough to allow any choice. The majority chose watch-and-wait or some form of radiosurgery/radiotherapy over surgical resection. Sorry, but I no longer have a bookmark for either study.
Nevertheless, it is wonderful that we who have an AN get to "choose our poison." And all forms of treatment have been refined over the years, resulting in better outcomes for all.
Best wishes,
TW