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February 1990

Treatment of Acoustic Tumors With Radiotherapy

Author Affiliations

Los Angeles, Calif

Arch Otolaryngol Head Neck Surg. 1990;116(2):161-162. doi:10.1001/archotol.1990.01870020037009

The history of acoustic neuroma surgery has long been shrouded in controversy. The early struggle between neurosurgeons and neuro-otologists over who should perform acoustic neuroma surgery, the variety of surgical approaches to achieve tumor removal, and the disagreement about what constitutes actual hearing preservation have served mainly to make a difficult situation for patients with acoustic neuromas a confusing one as well. With the establishment of the "gamma knife" radiation treatment centers in the United States and more frequent treatment with stereotactic proton-beam therapy, the patient is no longer left merely to make a choice of who will perform the surgery or how and where to have surgery, but whether to have surgery at all.1,2

Stereotactic radiation therapy (more commonly called radiosurgery by the radiotherapists using the technique) was introduced by Leksell in 1951. Unlike conventional fractionated radiation, which relies on the difference in biological radiosensitivity between adjacent

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