Expert: Claes-Gustaf Nordquist, M.D. - 9/3/2009

Question
I have been diagnosed with unilateral acoustic neurinoma.The size is about 2.5 cm
Should I have it removed or opt for radiosurgery to make it small or control it? I am worried about facial nerve damage. I am told the hearing will definitely go with surgery. What if radiosurgery does not work? Will radiosurgery make a normal surgery, at a later date, more complicated and more risky, if unsuccessful in itself?
Tank you in adfvance. Please help me as soon as possible. I have to make  adecision soon.

Best regards

Jamshid

Answer
If I were in your shoes I would definitely opt for radiosurgery (GammaKnife/Leksells kula)! There is no reason why it should not work in your case! The size of it is ideal for that treatment. The risk of hearing impairment on that side is big even with this treatment but somewhat smaller than with surgery. But other risks are definitely smaller. I have previously recommended patients in Denmark this treatment. And as far as I know it did go well in all cases. One of them even had it done in Sweden (The Karolinska University Hospital in Stockholm) after my recommendations. That patient only had some temporary balance problems - as can be expected in all treatments of this problem - after treatment but they soon passed away. The risks are definitely smaller in every way than with surgery! So that is what I do recommend! Good luck!