Acoustic Neuromas: Gamma Knife vs. Surgery

Acoustic Neuromas: Gamma Knife vs Surgery

Following a diagnosis of an acoustic neuroma, your doctor will begin to discuss potential treatment options with you. For some patients, monitoring will be sufficient. However, others will require some form of active intervention, which can include traditional surgery, Gamma Knife radiosurgery or a combination approach.

While your doctor will discuss the treatment plan he or she feels will be most appropriate for your case, it can be helpful to have an understanding of your condition and the treatment options before you discuss your case together. This will enable you to play a more active role in the conversation and development of your treatment plan.

About Acoustic Neuroma

An acoustic neuroma (also known as vestibular schwannoma) is a benign brain tumor that arises from the nerve responsible for balance, the vestibular nerve. Being benign means the tumor will not spread to another site of the body. However, it can still cause unpleasant effects and require treatment if it impinges on nearby tissues.

Acoustic neuromas are usually diagnosed in people 30 to 60 years old. Because they tend to grow slowly, they may go undetected for a number of years and are sometimes discovered when your doctor is doing imaging for another condition. Most patients have a vestibular schwannoma on only one side of the brain (there is a vestibular nerve on both the right and left side), except for those patients who have a rare hereditary disorder called Neurofibromatosis Type 2.

Treating Acoustic Neuroma: Gamma Knife vs. Surgery

If your doctor has recommended treatment for your acoustic neuroma, there are generally two options, each with the goal of reducing the size of your tumor as much as possible. The first approach is traditional surgery, and the second is Gamma Knife radiosurgery, a specialized form of radiation therapy. Each can be used individually or in a combination approach, and your doctor will recommend the approach he or she feels will be most appropriate in your case.

Gamma Knife radiosurgery is not a surgical procedure and involves no incisions. Instead, it is an advanced form of radiation surgery that uses multiple focused beams to target treatment directly at your tumor, sparing the healthy surrounding brain tissue. There is no hospital stay and less unpleasant side effects than with traditional radiation therapy.

On the other hand, in traditional surgery, the neurosurgeon will access your tumor and remove as much as possible, which may be all or only a portion of the tumor. This is done while you are asleep in a hospital setting and does require a hospital stay. Sometimes surgery is followed up with Gamma Knife radiotherapy in a combination approach to eliminate any remaining tumor cells.

When to Choose Gamma Knife, When to Choose Surgery

Your doctor will recommend the treatment option he or she feels will be most appropriate for you based on the size and location of your acoustic neuroma, as well as your individual health factors. However, there are some instances when one approach is commonly favored over the other.

If your tumor is very large, surgical resection may be the preferred approach, as Gamma Knife alone may not eradicate all of the tumor cells. Likewise, surgery is sometimes preferred in younger patients. On the other hand, some patients are not good candidates for surgery due to age, complicating health conditions or other factors, in which case minimally invasive Gamma Knife will likely be the initial treatment approach.

Benefits & Risks of Each Treatment Option

As your doctor develops your treatment plan, he or she will take into consideration the risks and benefits associated with each option in relation to your individual condition to determine the most appropriate treatment path for you.

Gamma Knife Radiosurgery


  • Minimally invasive procedure, with no incisions
  • Less pain and shorter recovery time than traditional surgery
  • No hospital stay required
  • No risks commonly associated with surgery, including anesthesia reactions and infection
  • Available when a patient cannot undergo traditional surgery


  • Side effects associated with radiation therapy, including headache, nausea and fatigue
  • Risk of delayed swelling months later (treatable with medications)

Traditional Surgery


  • Once a tumor is removed, recurrence is unlikely
  • If complete resection is not possible, can combine with Gamma Knife radiosurgery


  • Risks associated with any surgical procedure, including anesthesia reactions and infection
  • Risk of damage to the facial nerve, resulting in temporary or permanent muscle weakness
  • Risk of damage to the vestibulocochlear nerve, affecting hearing
  • Hospital stay required
  • Longer healing time with more discomfort than Gamma Knife radiosurgery

The Treatment Path Right for You: Acoustic Neuroma Gamma Knife vs Surgery

Whether you already have your procedure scheduled or have only been recently diagnosed, having a better understanding about your acoustic neuroma treatment options can improve your discussions with your doctor and set your mind at ease about your treatment.

Take the information you’ve learned into your next appointment, including any questions you may still have, to carry on the discussion with your personal doctor. He or she will be able to best explain the factors taken into consideration when recommending one treatment over another. Because you’ve taken the time to learn more on your own, you will likely find that your conversation is even more meaningful, giving you peace of mind about your treatment choices.

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