Intratympanic steroid treatment

[TylersNana]

Has anyone undergone this treatment? I have been 'auditioning' docs for treatment options. Up to this point everyone else has said fractionated radiation is the way to go. This is a highly regarded radiation oncologist at St. Louis University with education from Stanford and Harvard so his credentials are pristine. He says the steroids will help with my #1 complaint, dizziness. He says that since my MRI shows no tumor growth in 2 years that we should address the dizziness since radiation won't help that. Part of me agrees completely but the other part says I still have this unpredictable thing growing in my head...... any thoughts?

[PaulW]

Intratympanic steroids or gentamicin.
Gentamicin is toxic to the balance organ and will kill it off. There is a risk of compromised hearing from the treatment. But it does often stop the dizziness. There is also fractionated radio surgery or fractionated radiotherapy. They are quite different.
If your hearing is already gone, gentamicin and watch and wait seem to be a very reasonable options to me because around 40-70% of small ANs depending on the study don't grow.

With fractionated radiotherapy you can only receive that treatment once, your lifetime dose of radiation means you cannot have a second radiotherapy treatment.

If he is Stanford trained he is probably influenced by the 3 session radio surgery technique developed at Stanford, using Cyberknife.

I personally feel cyberknife is a really good option. I chose single session Cyberknife as my treatment option. There is a lot of debate in the radio surgery world on the benefits or not of fractionation for ANs
I read a physics paper about it, and it seems to me with acoustic neuromas going beyond 5 sessions is pointless and detrimental, and if fractionation does help 3 sessions appears to be optimal.