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Weill Cornell Medicine

weill                                 Dr. Samuel H. Selesnick 
                                      
Dr. Philip E. Stieg

 

Sponsor Spotlight

The Acoustic Neuroma Program at Weill Cornell Medicine is dedicated to delivering advanced treatments to patients affected by these tumors. The multidisciplinary team, led by neurosurgeon Dr. Philip E. Stieg and neurotologist Dr. Samuel H. Selesnick, offers a wide variety of leading-edge treatment options.

The acoustic neuroma specialists at Weill Cornell Medicine are also expert diagnosticians with access to advanced MRI techniques that allow for earlier diagnosis. Small tumors, diagnosed earlier, are much easier to treat and have better outcomes than those that expand outside the internal auditory canal.

Our experts evaluate each patient and recommend the best course of treatment based on a variety of
factors, with the goal of achieving the best possible outcome.

Call Dr. Stieg’s office at 212-746-4684 or Dr. Selesnick’s office at 646-962-3277, or visit www.weillcornellbrainandspine.org.

Sponsor Content

 Is Surgery the Best Option for an Acoustic Neuroma?

 A patient diagnosed with an acoustic neuroma may be offered several treatment options, from simple monitoring to surgery. The best option for any individual patient is the one that is appropriate to their age and health, the size and location of their tumor, and the severity of their symptoms. Treatment options include:

 

Watch and wait. If a tumor is small, and not causing symptoms, the best treatment option may be no treatment at all. Regular MRI scans to monitor the tumor for growth may be all that’s needed. For patients whose tumors are larger, or are causing symptoms, intervention may be needed to prevent the worsening of symptoms. Continued growth of a tumor can also cause compression of surrounding brain tissue.

 

Stereotactic radiosurgery.  This minimally invasive option is not traditional surgery, but a high-tech procedure that directs targeted beams of energy at the acoustic neuroma. (Many patients are familiar with the brand names Gamma Knife or CyberKnife — these are forms of stereotactic radiosurgery.) The procedure may be performed in either a single session or in multiple lower-dose sessions, with the goal of stopping the tumor’s growth. The effects of stereotactic radiosurgery are not immediate, but rather take place over time as the tumor responds to the treatment.

 

Resection surgery. Resecting, or removing, the tumor is a microneurosurgical procedure that produces immediate results. It is also usually the best option for larger tumors, where stereotactic radiosurgery is less effective and less safe. The surgical team includes both a neurosurgeon and a neurotologist, who work as a team on this delicate procedure, as well as a neurophysiologist to monitor the nerves that are being compressed by the tumor. This kind of teamwork provides an excellent foundation for successful outcomes.

 

There is no one-size-fits all approach to acoustic neuromas, and the most important aspect of the treatment decision is that it be individual, and made with the total well-being of the patient in mind. Dr. Philip Stieg and Dr. Samuel Selesnick, two of the country’s top experts on acoustic neuromas, work together to develop the best treatment plan for each patient.


4 Things Your Doctor Wants You to Know about Acoustic Neuroma

By Dr. Samuel Selesnick & Dr. Philip Steig

An acoustic neuroma is a complicated tumor, and a patient diagnosed with one usually has to learn a lot about it, quickly.Many turn for information to the internet,which can provide a basic education on these benign tumors — but may provided some misinformation as well. Dr. Philip Stieg and Dr. Samuel Selesnick, two of the country’s top experts on acoustic neuromas, have put together a list of the four things they would most like patients to know about acoustic neuromas.

1Surgery is not the only option

If an acoustic neuroma is not growing or posing any threat to surrounding nerves or tissue, or if the patient is older and surgery would pose too great a risk, simply monitoring it may be the treatment of choice.

If treatment is needed and the tumor is small, it may be possible to treat it with stereotactic radiosurgery (SRS) instead of surgery. SRS is a rapidly developing technique requiring highly trained surgeons using the most sophisticated equipment — such as the Gamma Knife, CyberKnife, proton beams, and linear accelerators.

Treatment may be given in either a single session or in multiple lower-dose sessions (known as fractionated radiosurgery).

Results are not immediate — the goal is to control growth of the tumor, or reduce it substantially, over the course of months or years. Stereotactic radiosurgery has the advantage of being noninvasive and therefore lower risk than open surgery, but it does carry a significant risk of hearing loss.

2. But surgery is often the best option

In most cases, micro-neurosurgery to remove an acoustic neuroma can stop the tumor from progressing. Unlike stereotactic radiosurgery, surgery produces immediate results and can be used on a tumor of any size. (Stereotactic radiosurgery is not usually effective against larger tumors.)

The surgery to remove an acoustic neuroma is extremely delicate and may take several hours to complete. The cranial base surgical team will choose from several possible approaches; the choice of approach depends on the size of the tumor, the age and health of the patient, and hearing preservation.

3. It takes a village (or a multidisciplinary team, at least)

The cranial base surgery team may include neurosurgeons and neurotologists who perform micro-neurosurgery to remove acoustic neuromas.

During the surgery, a neurophysiologist performs electrophysiologic monitoring of the nerves compressed by the tumor, so the nerves can be observed throughout the procedure to protect their function.

Experienced anesthesiologists are also integral members of the cranial base team. This team approach to surgery provides the best chances for a successful outcome.

4. Numbers do matter

Multiple studies have shown that, for any surgery, the experience level of the surgeon has a great impact on outcomes. Those who do the most of any given procedure almost always have the best results.

 

Note: In no case does ANA endorse any commercial product, physician, surgeon, medical procedure, medical institution or its staff.

 

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