Radiosurgical Treatment for Acoustic Neuroma

What is radiosurgery?

Radiosurgery is a non-invasive treatment that uses focused radiation to stop tumor growth while minimizing damage to surrounding tissues. It is often considered for tumors under 2.5–3 cm.

Common Questions to Ask Your Care Team:

• How many acoustic neuromas have you treated, and what complications have you seen?
• What symptoms or side effects are common after treatment?
• Will the procedure be a single dose or multiple sessions?
• Which type of radiosurgery do you recommend (Gamma Knife, LINAC, proton beam), and why?
• How often should I have follow-up MRIs?
• Are there any activity restrictions after treatment?
• If my tumour grows again, what are the next steps?

What to Expect During Treatment:

Gamma Knife Radiosurgery

Preparation & Procedure:

• A rigid stereotactic head frame is attached under local anesthesia to keep the head perfectly still
• No incision or hair shaving is typically needed
• A specialized MRI is done to map the tumour
• Radiation is delivered in a single session using 192–201 cobalt-60 sources, precisely targeting the tumour

Recovery:

• Outpatient procedure; most patients go home the same day
• Mild headaches, balance issues, or hearing changes may develop gradually
• Follow-up MRI is usually done annually

Ideal For:

Small to medium tumours requiring highly precise, single-session treatment

LINAC (Linear Accelerator) Radiosurgery

Preparation & Procedure:

• Uses high-energy X-rays delivered from a machine that rotates around the head
• Immobilization can be frame-based (rigid head frame) or frameless (custom mask)
• Can be delivered as a single session or multiple smaller doses (fractionated radiosurgery)
• Tumor and surrounding tissues are mapped using MRI and CT scans for precise targeting

Recovery:

• Outpatient procedure; most patients return to normal activities quickly.
• Mild headaches, balance issues, or hearing changes may develop gradually.
• Annual follow-up MRI is typically recommended.

Ideal For:

• Tumours of various sizes or locations, especially when customized radiation shaping is needed

Key Takeaway:
Both Gamma Knife and LINAC aim to stop tumor growth while protecting surrounding brain and nerve tissue. The main differences are in the type of immobilization and flexibility in dosing. Your radiation team will help determine which approach is best for your situation.

Possible Side Effects:

Headaches, balance issues, hearing changes, or facial weakness may appear gradually over months. Always report new symptoms to your physician.

Microsurgical Removal of Acoustic Neuroma

Questions to Ask Your Surgeon:

• How many acoustic neuromas have you removed, and what are your facial nerve and hearing preservation rates?
• Will the tumour be fully removed in a single surgery?
• What complications might occur (infection, bleeding, CSF leaks)?
• How long will hospitalization last, and what follow-up care is required?
• Will a team of specialists assist with my surgery?

Preparing for Surgery:

• Outpatient admission may be possible, but preoperative tests and anesthesiology consultations are required.
• Bring a list of all medications and personal health information.
• The surgeon may mark the tumor ear for accuracy.

During Surgery:

• Surgery is performed under anesthesia with continuous monitoring of vital signs and nerve function.
• Length of surgery depends on tumor size and complexity.

Recovery in Hospital:

• You may spend 24–48 hours in intensive care for monitoring.
• Expect temporary devices like IVs, catheters, and head dressings.
• Gradually progress from liquids to regular diet; get up and move as advised.
• Facial weakness may occur. Eye care and facial exercises may be needed to protect and strengthen muscles.
• Balance may be affected; activity and walking help retrain the system.

Going Home:

• Follow instructions for eye care, facial exercises, and incision care.
• Resume daily activities gradually, with support from family if needed.
• Walking programs aid in regaining strength and balance.
• Specialized hearing aids (CROS or BICROS) may help if hearing is lost on one side.

Tips for Recovery

• A positive mental attitude supports faster recovery
• Support from former patients or local acoustic neuroma groups can be invaluable
• Stay in touch with your health care team for guidance throughout recovery