The Neurotologist as Gamma Knife Radiosurgeon

What Should We Anticipate for the Future?

Gamma Knife radiosurgery continues to evolve rapidly and advances are being made in improving accuracy, effective radiation dose, and other variables necessary to maximize patient outcome. Gamma Knife radiosurgery, just as any other treatment method, has advantages and disadvantages that must be discussed with a patient who has an acoustic neuroma. An informed decision to pursue observation, microsurgery, or stereotactic radiosurgery-or a combination of these methods-must be made, and it remains the responsibility of the surgeon to provide a balanced view as to the relative advantages and disadvantages of each method. With the introduction of new technologies that will be able to address disease extending to the clavicles, our entire otolaryngology community should prepare to meet the opportunity to integrate stereotactic radiosurgery into their practices.

References

1. Wackym PA, Runge-Samuelson CL, Poetker DM, et al. Gamma knife radiosurgery for acoustic neuromas performed by a neurotologist: early experiences and outcomes. Otol Neurol 2004;25:752-61.

   [Context Link]

2. Poetker DM, Jursinic PA, Runge-Samuelson CL, Wackym PA. Distortion of magnetic resonance images used in Gamma Knife radiosurgery treatment planning: implications for acoustic neuroma outcomes. Otol Neurotol 2005;26:1220-8.

   [Context Link]

3. Pollock BE, Lunsford LD, Kondziolka D, et al. Vestibular schwannoma management. Part II. Failed radiosurgery and the role of delayed microsurgery. J Neurosurg 1998;89:949-55.

   [Context Link]

4. Watanabe T, Saito N, Hirato J, et al. Facial neuropathy due to axonal degeneration and microvasculitis following Gamma Knife surgery for vestibular schwannoma: a histological analysis. J Neurosurg 2003;99:916-20.

   [Context Link]

5. Iwai Y, Yamanaka K, Ishiguro T. Surgery combined with radiosurgery of large acoustic neuromas. Surg Neurol 2003;59:283-9.

   [Context Link]

©2007 The Triological Society