Q&A Sessions: Schwannoma
John Y.K. Lee, MD will be
answering your questions about Gamma
Knife radiosurgery. Click here to ask
your question.
Mary in AZ asks:
I have a 1.1cm vestibular
schwannoma. I still have hearing albeit
distorted on the affected side. What is the
difference in Gamma Knife versus cyberknife
in chances of hearing retention? I have the
option for either here.
Dr. Lee responds:
There are many reasons why Gamma Knife
is superior to other technologies.
For example, Gamma Knife has the longest
proven track record for treating acoustic
neuromas. It is the gold standard by
which all other competitors are measured.
The Gamma Knife is designed only to
treat brain lesions and therefore the
users of Gamma Knife are focused on
brain lesions. Nothing is more accurate
than the Gamma Knife. All other competitors
always compare themselves to Gamma
Knife.
If you have any additional questions or
would like to schedule an appointment,
please call us at 800-789-PENN. You can
also request
an appointment online. |
Diane asks:
My 78-year-old mother was recently
diagnosed with a schwannoma vagus, which
is close to her carotid artery. Is Gamma
Knife something that could help her or
would she require traditional surgery?
Dr. Lee responds:
Gamma Knife can definitely be used
in this situation with great success
and safety. If you would like to schedule
an appointment, please call us at 800-789-PENN
or you can also request
an appointment online. |
Dave asks:
For a 3.0 cm dumbell shaped schwannoma of
the jugular foramen, is the preferred
treatment operative, gamma knife, or
other?
Dr. Lee responds:
Gamma
Knife is the preferred treatment
for schwannomas of the eighth nerve
if the tumor is small or medium-sized.
Schwannomas of the lower cranial nerves
also respond favorably to Gamma Knife,
and I would be happy to review your
films to determine eligibility for
Gamma Knife. |
Jeff asks:
I had a 4.2 cm jugular foramen schwannoma
removed in December of 2005, it now is
growing back. Is it better to wait and
watch or have Gamma Knife as soon is
possible.
Dr. Lee responds:
Timing of the procedure depends upon each
individual's unique situation. I would be
happy to review your case. |
Natasha asks:
I have been diagnosed with a vestibular schwanoma
12mmx7mmx5mm. I have extreme vertigo
and debilatating dizziness but minimal
hearing loss. Can Gamma Knife help my
symptoms within a reasonable amount of
time or shall I expect them to worsen
before improving?
Dr. Lee responds:
For your size tumor, Gamma Knife has been
shown to have the best results with respect
to hearing loss, facial nerve preservation,
and quality of life as compared to conventional
surgical resection. You are a great candidate
for Gamma Knife, and I would be happy
to discuss the specific advantages and
disadvantages. If you would like to schedule an appointment,
please call 1-800-789-PENN (7366) or request
an appointment online. |
Rick asks:
My physician has said I have either a trigeminal
schwannoma or a meningioma. Can the Gamma
Knife be used to treat these conditions?
Dr. Lee responds:
Gamma Knife can control benign tumors such
as meningiomas and schwannomas >90% of
the time at a follow-up time period of
ten years. Longer term results are still
being collected. If you would like to schedule an appointment,
please call 1-800-789-PENN (7366) or request
an appointment online. |
Stan asks:
I was diagnosed with a Schwannoma 4cm(h)x
1.5cm(w)x 2.4cm(d). From MRI & Angiogram,
acoustic neuroma/glomus jugulare/glioma
were ruled out. It is located within
left cerebellopontine angle with significant
inferolateral extension into the region
of the jugular foramen. Giving the size
of the tumor, would I be a good candidate
for Gamma Knife instead of surgery?
Dr. Lee responds:
Most cerebellopontine
angle tumors can be treated with Gamma
Knife. However, in your specific case, I
would want to review the films and your clinical
exam prior to making any specific recommendations. If you would like to schedule an appointment,
please call 1-800-789-PENN (7366) or request
an appointment online. |
Raaghavendra asks:
I had been operated on for left Cp angle
schwannoma eight years ago. Post-operative
complications lead to CSF leakage and
subsequently took attempts to stop it.
I'm presently diagnosed for jugular foramen
schwannoma of 3-5cm in size. I consulted
several neurosurgeons and most of them
are against Gamma Knife treatment.
Please let me know the complications
(if any) or if you need more information
from me. Please suggest the best solution
for these type of tumors. Presently I
am asymptomatic. What I have understood
from the report is that tumor is both
inside and as well outside the cranial
activity. Please advice the best solution. Dr. Lee responds:
Gamma Knife for larger tumors like this is
very difficult, because of potential
complications. In addition, it appears
that you have a genetic predisposition
to develop tumors and thus the success
rate of Gamma Knife may not be very good. |
Rita asks:
I am 35 and diagnosed with a seventh nerve
schwannoma. It has grown 1mm in five
months. Is the Gamma Knife procedure
successful with these tumors?
Dr. Lee responds:
Gamma Knife radiosurgery can control vestibular
schwannomas (acoustic
neuromas) which arise from the eighth
cranial nerve. Although the diagnosis
and thus experience with seventh nerve
schwannomas is not as bountiful as that
with vestibular schwannomas, there is
every reason to believe that Gamma Knife
should be successful in managing these
tumors. Please call 1-800-789-PENN (7366) to
schedule an appointment. You can also request
an appointment online. |
Ellie asks:
My friend has a trigeminal schwannoma compressing
the brain stem notably. I am wondering
if Gamma Knife is an option. Most of
the mass is cystic.
Dr. Lee responds:
Gamma Knife radiosurgery is definitely an
option for trigeminal schwannomas as
long as the size of the tumor is appropriate. If you or your friend would like to
schedule an appointment, call 1-800-789-PENN
(7366) or you can also request
an appointment online. |
RWilson asks:
I have been diagnosed with benign trigeminal
schwannoma (2.5 x 3 cm) located cavernous
sinus within 2mm of optic nerve. The
surgeon has recommended Gamma Knife versus
craniotomy at this time. Can you give
me information as related to surgery
versus the Gamma Knife? They said that
within 3 mm of optic nerve is risking
damage to eye function, in my case double
vision.
Dr. Lee responds:
Without seeing the films, it is difficult
to advise you. However, there is a big
difference between the radiation sensitivity
of the optic nerves and the oculomotor,
trochlear, and abducens nerves. The optic
nerve (II) is very radiation sensitive
which can result in blindness. Fortunately,
the optic nerve is unlikely to be damaged
when performing Gamma Knife for a trigeminal
schwannoma, because it is located farther
away. In contrast, the oculomotor (III), trochlear
(IV), and abducens (VI) nerves are very
radiation resistant and damage to them
would result in double vision. During
the Gamma Knife radiosurgical procedure,
these nerves receive high doses but are
unlikely to be damaged, since they are
radiation resistant. |
MAA asks:
Beaumont Hospital in Royal Oak, MI.
received their Gamma Knife 4/5
months ago. I was diagnosed with
acoustic nerve schwannoma in my
left ear measuring 1.3cm x 275mm.
My doctor advised that I am a good
candidate for this procedure. I
asked him how many procedure he
has performed and he said 20. My
doctor wants to monitor the growth
for 8 months. My balance is off,
I have no pain, or numbness in
my face and no slurring of speech.
I fell downstairs in January 07
and fractures my ankle and leg.
After the cast came off I was so
dizzy. About two months ago I woke
up not able to hear the traffic.
I had a MRI, MRA, Doppler, ENG
I have loss of hearing (45%) and
there is a nervousness in the ear
area. How many operations for an
acoustic tumor have you performed?
Why am I being monitored? Whoever
performs this procedure on me must
be fully experienced.
Dr. Lee responds:
We perform approximately 40 Gamma
Knife radiosurgical procedures
for acoustic neuromas per year
at the Penn Gamma Knife Center.
In addition, we perform approximately
250 Gamma Knife radiosurgical
procedures total per year. I
would be happy to discuss your
case with you. Please contact
my office to arrange a phone
consultation. |
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Knife are U.S. federally registered trademarks
of Elekta Instrument S.A., Geneva, Switzerland.
Photo credits: Susan Pardys, Elekta, Inc.
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