The risk of stereotactic radiotherapy for acoustic neuroma. (Editorial).The value, indications, and complications of stereotactic stereotactic /ster·eo·tac·tic/ (-tak´tik) 1. characterized by precise positioning in space; said especially of discrete areas of the brain that control specific functions. 2. pertaining to stereotactic surgery. radiotherapy versus neuro-otologic surgical removal has been increasingly more frequently the subject of discussion at our scientific meetings. Most recently, at the November meeting of the New York New York, state, United States New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of Otological o·tol·o·gy n. The branch of medicine that deals with the structure, function, and pathology of the ear. o Society, which I attended as a guest, a case was presented by a member involving the continued progressive growth of a patient's tumor tumor: see neoplasm. that had been treated by stereotactic radiotherapy. In this month's issue of the Ear, Nose & Throat Journal, Steven Y. Ho, MD, and John F. Kveton, MD, report the tragic case of a 14-year-old girl who had bilateral acoustic neuromas Acoustic Neuroma Definition An acoustic neuroma is a benign tumor involving cells of the myelin sheath that surrounds the vestibulocochlear nerve (eighth cranial nerve). treated by stereotactic radiotherapy, with subsequent rapid growth of the irradiated tumors and brain-stem compression resulting in death. They point out that failure of radiation therapy to arrest growth of NF2 acoustic tumors acoustic tumor Acoustic neuroma, see there is 24% and of non-NF2 tumors, 12%. A growing number of cases of malignant change following radiation of acoustic neuromas is being reported in the literature. There is a place for radiation therapy in the treatment of acoustic neuroma for patients who cannot safely withstand surgery for medical reasons and who have enlarging tumors. (1) It is natural that patients want to avoid surgery if a benign, successful alternative treatment is available. It is clear, however, that radiation therapy for acoustic neuroma can have very serious complications, and patients need to be informed about those possible complications before treatment. Happy holidays to you all!! JACK L. PULEC, MD Editor-in-Chief EAR, NOSE & THROAT JOURNAL Reference (1.) Pulec JL. Acoustic neuroma surgery in geriatric patients. Ear Nose Throat J 1999;78:429-42. |
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