Deciding between FSR and GAMMA

[lark114]

I was diagnosed last week with 1.6 cm right AN.  My symptoms were primarily balance issues, hearing loss and wonky head.    My word recognition is 88% and I would like to preserve it for as long as possible.  This week I developed tinnitus.  I am still in the deciding portion of what I want to do.  I live in the Philadelphia area and have gone to Temple and Jefferson.  In the next several weeks, I will be going to Penn and Johns Hopkins for their opinions.

So far no one is recommending surgery, but there is disagreement about what kind of radiation I should have.  Temple says GAMMA and Dr. Andrews at Jefferson wants to do FSR for 5 weeks as he thinks this will be the best way to preserve my hearing.  I am leaning towards FSR, but would like any thoughts, experiences, outcomes.  Has anyone had FSR with Dr. David Andrews?  I really liked him and he made the most sense to me.  Thanks.

[arizonajack]

The main difference between the two radiation methods is that GK is a one time high dose of radiation and FSR consists of numerous low doses. The consensus seems to be that a series of lower doses are less likely to harm healthy tissue.

My own AN hearing was all gone by the time I was diagnosed so I had nothing to lose by getting GK and getting it over with.

I have some links to articles comparing the various radiation methods and they touch on hearing preservation.

The first link is a 2004 article from the Barrow Neurological Institute in Phoenix (where I had my GK). Two of the contributors were on my team: Dr Porter - neurosurgeon and Dr Brachman - radiation oncologist. Page 36 begins the discussion of FSR.

http://www.thebarrow.org/stellent/groups/public/@xinternet_con_bni/documents/webcontent/203563.pdf

The next article is more recent:

http://emedicine.medscape.com/article/857604-overview#showall

The next link is a series of undated articles from the Staten Island University Hospital. One article addresses hearing preservation. The others are interesting. Toward the bottom (I don't know why) the articles become unreadable because of the font size but you can copy and paste them into a word document and enlarge the font so you can read them.

http://anworld.com/newbies/LedermanPapers.html#article7

Next up is an article on the long term follow up after GK:

http://thejns.org/doi/pdf/10.3171/2012.7.GKS12783

You might find more current studies by googling. The above came out of my own research in 2012 and I haven't done any more research since then.

[sandyinwisconsin]

Hi - I did have 26 treatments of radiation like Dr. Andrews is recommending.
I went to U.W. Madison, WI and had mine done 1 1/2 years ago.  So far I'm doing
fine and I am no worse than before I started the radiation.  I too have about around 80% of my hearing,
and I still have it so far.  If you want to save your hearing, it's recommended you have the radiation
done befoe you lose any more.  I'm available for any questions. Please send me a personal message if you
would like. 

Have you listened to all the speakers who spoke at the 2013 ANA Symposium in LA?  Dr. Andrews
was one of them.  After I heard what he had to say, I realized there was light at the end of the tunnel, and it
gave me the courage to go through with radiation. 

Sandy