Radiosurgery is used to treat some small and medium-sized tumors when patients do not want microsurgery, are in their mid-60s or older, or are otherwise not good surgical candidates. For this approach, we use one of two state-of-the-art technologies.
The GammaKnife®, which has the longest track record, delivers more than 200 beams of radiation with pinpoint accuracy in a single session. As far as tumor control, GammaKnife® is the gold standard for radiosurgical treatment. At Keck Medicine of USC, we have the Perfexion™, the latest model of the GammaKnife®.
The CyberKnife®, which is used to treat tumors that are lower in the skull base, allows surgeons to fractionate treatment ─ delivering the radiation dosage in more than one session. Because some medical experts believe that the CyberKnife® and fractionated therapy cause less damage to nearby tissue and may improve hearing preservation, it is the radiosurgery technique most frequently used to preserve hearing. We currently are collecting data to analyze this question.
Both methods are reported to be 70 to 95 percent effective in controlling tumor growth, depending on the size of the tumor and whether or not it was growing prior to treatment.
For patients with small tumors who have good hearing and for those with larger tumors, surgery using miniaturized instruments and a microscope is usually the best option. Whether microsurgery is recommended because of tumor size, symptoms or other factors, our experienced microsurgical team safely removes the tumor using one of three advanced techniques: the translabyrinthine, retrosigmoid or middle cranial fossa surgical approach.
Our primary emphasis is to utilize state-of-the-art pretreatment imaging and microsurgical technique to preserve normal facial function. Additionally, our combined Neurotology and Neurosurgery expertise uniquely positions us for hearing preservation when possible using either microsurgery or radiation.