Gamma Knife and balance afterwards

[nyartist]

I just posted this in another place in the forum but wanted to repeat it here. My girlfriend has 1 cm AN totally contained within the auditory canal and has been meeting with some of the top surgeons and radio surgeons here in the NYC area these past two weeks. Here's the question: she has balance issues and about 50% hearing loss in the left ear. Is it likely that the balance issues would improve after GK? would they likely remain the same or get worse? We're hoping that GK is the right way to go and are still in the information gathering mode. Dr. Kondziolka responded in an email just yesterday that he felt she would be a good candidate for GK but we're really concerned about outcomes - possible outcomes, after GK. We've also met with Dr Golfinos here in NYC and he's still undecided about treatments and wants to consult with his surgeon first. But again, her question is really about what to expect after GK regarding a change in the balance problems she's experiencing now. Her balance issues aren't that bad but bad enough to affect her quality of life.

[sgerrard]

First, I would say you are right to consider balance issues before doing radiation. At 1 cm, there should be time to get it sorted out.

If possible, I would ask one of the doctors to refer her to a vestibular lab, and get a set of tests run to assess the balance nerve function, including ENG. This can help determine the extent and nature of balance nerve dysfunction, including which branches are affected. The results may help a doctor advise you on treatment.

Radiation treatment does not directly affect balance function one way or the other. That is in contrast to surgery, which typically includes snipping the balance nerve on the AN side, leaving you with one good balance nerve on the other side.

In many cases, the balance nerve signal on the AN side either remains usable, or fades away over time on its own. The brain can readjust to this quite well, with maybe a few bumps in the road along the way. When that is the case, radiation will work out fine.

However, if the balance nerve on the AN side ends up actively sending out jumbled signals after radiation, you could get stuck with serious vertigo problems. That's a scenario where surgery would be preferable, since it would snip the nerve and shut it down for good.

In my own case, I have a mild loss of balance nerve function on the lower branch, which makes me wobble a bit when making sharp turns, but doesn't affect me otherwise. That has remained the same before and after radiation treatment, and it is not expected to become a problem.

Best wishes,

Steve

[gordy]

artist i had gamma knife july 2007 for 1.5 tumor. i havent noticed a difference in my balance now as compared to before, but i never knew i had a balance problom. my hearing they claim is the same now as was before, but to me it seems worse. just thought id let you know my experirnce. good luck to you and your girlfriend.

[Kate B]

NY,
You shared:
< Is it likely that the balance issues would improve after GK? would they likely remain the same or get worse? We're hoping that GK is the right way to go and are still in the information gathering mode. Dr. Kondziolka responded in an email just yesterday that he felt she would be a good candidate for GK but we're really concerned about outcomes - possible outcomes, after GK.>

Doctor Kondziolka is an expert in Gamma Knife and UPMC is well reknown. What did he say about balance?

One of the things I like about UPMC is that they publish research and track their data relative to GK. It goes through a process  called peer review, which means that the research must follow certain protocals.  Peer review is the gold standard in medicine.

Here is a quote about peer review from a doctor:
“IT (peer review) is the process by which scientific articles or data is reviewed and scrutinized by other (usually 3-6) people (neurosurgeons, radiation oncologists etc), prior to it being suitable for publication in a medical journal. This (peer review) is the highest standard in medicine."

Here is information from the Nat'l Lib of Med, Librarian:
“Not all journals selected for Index Medicus are peer-reviewed , nor do we designate which journals are reviewed.  You can look up a journal title in Ulrich's International Periodicals Directory published by RR Bowkerand if it has the designation "refereed" the journal is peer-reviewed.â€?C. Williard e-mailReference librarian at the Nat’l Llib of Med