CYBERKNIFE IN THE TREATMENT OF SPINALCORD TUMOURS
When treating benign spinal tumors with radiosurgery, the primary intermediate objective is to stop all tumor growth. Over the long term, these tumors will gradually shrink in size which may take a period of several years. Preliminary results with CyberKnife radiosurgery for meningioma and schwannoma show excellent control of tumor growth.
Treatment with CyberKnife radiosurgery utilizing a hypofractionated treatment regimen was indicated for maximum local control and to minimize the chance of injury to the spinal cord.
Outcome and Follow-Up
At 3-month follow-up:
* Neck, shoulder and arm pain dramatically decreased
* Neck and left arm mobility much improved
* MRI study showed no progression of meningioma
9-month follow-up:
* Improved neck and left shoulder mobility
* Left arm strength increasing
* Some numbness in left upper arm but improved compared to last visit
12-month follow-up:
* Increased left shoulder and neck mobility
* Increased left arm function
* No new symptoms or problems
22-month follow-up:
* Left arm range of motion improved, arm strength stable,
mild residual weakness
* No new problems
* No neck pain
* Follow-up MRI reveals no evidence of tumor progression and stability
of the previously treated lesion
Conclusion
The patient has experienced significant improvement since undergoing stereotactic radiosurgery. MRI shows no evidence of tumor progression. Follow-up will occur on an annual basis with continued MRI surveillance.
SOURCE : http://www.utmedicalcenter.org/lib/file/manager/pages/cancer-institute/resources/-utmc-cyberknife-annual-report_011711.pdf
FOR MORE INFORMATION ON CYBERKNIFE YOU MAY BLOG YOUR QUERIES OR WRITE TO lakshmipriya_b@apollohospitals.com
Showing posts with label Accuray cyberknife. Show all posts
Showing posts with label Accuray cyberknife. Show all posts
Thursday, April 19, 2012
Saturday, March 3, 2012
Visual field preservation thru cyberknife radiosurgery
Visual field preservation after multisession cyberknife radiosurgery for perioptic lesions.
Adler JR Jr, Gibbs IC, Puataweepong P, Chang SD.
SourceDepartment of Neurosurgery, Stanford University Medical School, Stanford, California 94305, USA. jra@stanford.edu
Abstract
OBJECTIVE: The restricted radiation tolerance of the anterior visual pathways represents a unique challenge for ablating adjacent lesions with single-session radiosurgery. Although preliminary studies have recently demonstrated that multisession radiosurgery for selected perioptic tumors is both safe and effective, the number of patients in these clinical series was modest and the length of follow-up limited. The current retrospective study is intended to help address these shortcomings.
METHODS: Forty-nine consecutive patients with meningioma (n = 27), pituitary adenoma (n = 19), craniopharyngioma (n = 2), or mixed germ cell tumor (n = 1) situated within 2 mm of a "short segment" of the optic apparatus underwent multisession image-guided radiosurgery at Stanford University Medical Center. Thirty-nine of these patients had previous subtotal surgical resection, and six had previously been treated with conventional fractionated radiotherapy (6). CyberKnife radiosurgery was delivered in two to five sessions to an average tumor volume of 7.7 cm3 and a cumulative average marginal dose of 20.3 Gy. Formal visual testing and clinical examinations were performed before treatment and at follow-up intervals beginning at 6 months.
RESULTS: After a mean visual field follow-up of 49 months (range, 6-96 mo), vision was unchanged postradiosurgery in 38 patients, improved in eight (16%), and worse in three (6%). In each instance, visual deterioration was accompanied by tumor progression that ultimately resulted in patient death. However, one of these patients, who had a multiply recurrent adrenocorticotropic hormone-secreting pituitary adenoma, initially experienced early visual loss without significant tumor progression after both a previous course of radiotherapy and three separate sessions of radiosurgery. After a mean magnetic resonance imaging follow-up period of 46 months, tumor volume was stable or smaller in all other cases. Two patients died of unrelated nonbrain causes.
CONCLUSION: Multisession radiosurgery resulted in high rates of tumor control and preservation of visual function in this group of perioptic tumors. Ninety-four percent of patients retained or improved preradiosurgical vision. This intermediate-term experience reinforces the findings from earlier studies that suggested that multisession radiosurgery can be a safe and effective alternative to either surgery or fractionated radiotherapy for selected lesions immediately adjacent to short segments of the optic apparatus.
Source : http://www.ncbi.nlm.nih.gov/pubmed/18596432
For more information you may blog your comments or write to lakshmipriya_b@apollohospitals.com
Adler JR Jr, Gibbs IC, Puataweepong P, Chang SD.
SourceDepartment of Neurosurgery, Stanford University Medical School, Stanford, California 94305, USA. jra@stanford.edu
Abstract
OBJECTIVE: The restricted radiation tolerance of the anterior visual pathways represents a unique challenge for ablating adjacent lesions with single-session radiosurgery. Although preliminary studies have recently demonstrated that multisession radiosurgery for selected perioptic tumors is both safe and effective, the number of patients in these clinical series was modest and the length of follow-up limited. The current retrospective study is intended to help address these shortcomings.
METHODS: Forty-nine consecutive patients with meningioma (n = 27), pituitary adenoma (n = 19), craniopharyngioma (n = 2), or mixed germ cell tumor (n = 1) situated within 2 mm of a "short segment" of the optic apparatus underwent multisession image-guided radiosurgery at Stanford University Medical Center. Thirty-nine of these patients had previous subtotal surgical resection, and six had previously been treated with conventional fractionated radiotherapy (6). CyberKnife radiosurgery was delivered in two to five sessions to an average tumor volume of 7.7 cm3 and a cumulative average marginal dose of 20.3 Gy. Formal visual testing and clinical examinations were performed before treatment and at follow-up intervals beginning at 6 months.
RESULTS: After a mean visual field follow-up of 49 months (range, 6-96 mo), vision was unchanged postradiosurgery in 38 patients, improved in eight (16%), and worse in three (6%). In each instance, visual deterioration was accompanied by tumor progression that ultimately resulted in patient death. However, one of these patients, who had a multiply recurrent adrenocorticotropic hormone-secreting pituitary adenoma, initially experienced early visual loss without significant tumor progression after both a previous course of radiotherapy and three separate sessions of radiosurgery. After a mean magnetic resonance imaging follow-up period of 46 months, tumor volume was stable or smaller in all other cases. Two patients died of unrelated nonbrain causes.
CONCLUSION: Multisession radiosurgery resulted in high rates of tumor control and preservation of visual function in this group of perioptic tumors. Ninety-four percent of patients retained or improved preradiosurgical vision. This intermediate-term experience reinforces the findings from earlier studies that suggested that multisession radiosurgery can be a safe and effective alternative to either surgery or fractionated radiotherapy for selected lesions immediately adjacent to short segments of the optic apparatus.
Source : http://www.ncbi.nlm.nih.gov/pubmed/18596432
For more information you may blog your comments or write to lakshmipriya_b@apollohospitals.com
Tuesday, February 21, 2012
Nasopharynx Angiofibroma
Nasopharynx Angiofibroma
This 21 years old patient from Colombo Srilanka came to us in March 2010 with the following history.
He was diagnosed as a case of nasopharynx angiofibroma in 2005 after couple of episodes of nasal bleeding, he underwent surgery for the same, but his symptoms re-occurred within 8 months. CT scan revealed recurrence. He underwent re-excision in 2006. Again in 2008 he had recurrence and 3rd surgery was done. In January 2010 MRI scan revealed recurrent mass which measured 4.1x3.8x4.0 – Left nasopharynx with erosion of left Pterygoid plate and extension to extradural space. Patient being young and had faced multiple surgeries was very anxious. His parents were also stressed, we took up the case and subjected the patient for CyberKnife Radio surgery after proper planning and verification (patient received treatment from 3.3.2010 to 8.3 .2010).
Patient is on regular follow up. The follow up scans and volume analysis shows good response to treatment with couple resolution of disease. Patient is locally asymptomatic and is in a good job. His health has improved very well, looks handsome, Parents are having a nice smile in their face.
To know more about cyberknife you may blog your comments or write to lakshmipriya_b@apollohospitals.com
This 21 years old patient from Colombo Srilanka came to us in March 2010 with the following history.
He was diagnosed as a case of nasopharynx angiofibroma in 2005 after couple of episodes of nasal bleeding, he underwent surgery for the same, but his symptoms re-occurred within 8 months. CT scan revealed recurrence. He underwent re-excision in 2006. Again in 2008 he had recurrence and 3rd surgery was done. In January 2010 MRI scan revealed recurrent mass which measured 4.1x3.8x4.0 – Left nasopharynx with erosion of left Pterygoid plate and extension to extradural space. Patient being young and had faced multiple surgeries was very anxious. His parents were also stressed, we took up the case and subjected the patient for CyberKnife Radio surgery after proper planning and verification (patient received treatment from 3.3.2010 to 8.3 .2010).
Patient is on regular follow up. The follow up scans and volume analysis shows good response to treatment with couple resolution of disease. Patient is locally asymptomatic and is in a good job. His health has improved very well, looks handsome, Parents are having a nice smile in their face.
To know more about cyberknife you may blog your comments or write to lakshmipriya_b@apollohospitals.com
Vertigo and right side hearing loss - Acoustic neuroma
Vertigo and right side hearing loss - Acoustic neuroma
A 50 years old gentleman presented with complaints of vertigo and right side hearing loss. MRI brain showed a well defined intracranial hemorrhage soft tissue lesion on the right side, possibility of an acoustic neuroma (1.1 x0.6 x0.5 cm). He was seen by ENT specialist. Audiometry revealed profound SN hearing loss on the right side and was referred to me for cyber knife radio surgery. Patient underwent Cyber Knife radio surgery from 11.10.2010 to 15.10.2010. Subsequent follow up with MRI and volume analysis has resulted not only arrest of tumour but also significant reduction in the volume of lesion, indicating success of treatment.
This patient was treated at Apollo Speciality Hospital, Chennai and has shown significant progress through cyberknife treatment
To know more about cyberknife treatment you may blog your comments or write to lakshmipriya_b@apollohospitals.com
A 50 years old gentleman presented with complaints of vertigo and right side hearing loss. MRI brain showed a well defined intracranial hemorrhage soft tissue lesion on the right side, possibility of an acoustic neuroma (1.1 x0.6 x0.5 cm). He was seen by ENT specialist. Audiometry revealed profound SN hearing loss on the right side and was referred to me for cyber knife radio surgery. Patient underwent Cyber Knife radio surgery from 11.10.2010 to 15.10.2010. Subsequent follow up with MRI and volume analysis has resulted not only arrest of tumour but also significant reduction in the volume of lesion, indicating success of treatment.
This patient was treated at Apollo Speciality Hospital, Chennai and has shown significant progress through cyberknife treatment
To know more about cyberknife treatment you may blog your comments or write to lakshmipriya_b@apollohospitals.com
Thursday, February 9, 2012
CYBERKNIFE TREATMENT FOR ACOUSTIC NEUROMAS
CYBERKNIFE TREATMENT FOR ACOUSTIC NEUROMAS
An acoustic Neuroma, sometimes classified as vestibular schwannoma, is a noncancerous tumor which greatly affects the vestibulocochlear cranial nerve. This nerve is responsible for your perception of hearing and stability.
One treatment solution is cyberknife treatment . The reason for this treatment technique is to eliminate the tumor, particularly if it is already large enough to result in total deafness. Furthermore, a significant tumor can also affect and alter the capabilities of other regional organs.
The appearance of cyberknife approach is a less intrusive method for treatment is Cyberknife VSI’s noninvasive surgery for acoustic neuroma. This treatment procedure utilizes gamma radiation to eradicate the developing tumor and leave the site totally free of possibly damaging tumor cells. This type of intervention not simply guards healthy tissues, but produces minimal side effects, and boosts comfort for the patient when focusing on the cancer cells in a precise manner.
With cyberknife VSI’s noninvasive surgery for acoustic neuroma today, the apollo speciality hospital, chennai, India uses up-to-date research, technologically advanced technologies, and has professional physicians to deliver this revolutionary cyberknife treatment method for effective treatment of the acoustic neuroma.
To know more about cyberknife treatment you may blog your comments or write to lakshmipriya_b@apollohospitals.com
An acoustic Neuroma, sometimes classified as vestibular schwannoma, is a noncancerous tumor which greatly affects the vestibulocochlear cranial nerve. This nerve is responsible for your perception of hearing and stability.
One treatment solution is cyberknife treatment . The reason for this treatment technique is to eliminate the tumor, particularly if it is already large enough to result in total deafness. Furthermore, a significant tumor can also affect and alter the capabilities of other regional organs.
The appearance of cyberknife approach is a less intrusive method for treatment is Cyberknife VSI’s noninvasive surgery for acoustic neuroma. This treatment procedure utilizes gamma radiation to eradicate the developing tumor and leave the site totally free of possibly damaging tumor cells. This type of intervention not simply guards healthy tissues, but produces minimal side effects, and boosts comfort for the patient when focusing on the cancer cells in a precise manner.
With cyberknife VSI’s noninvasive surgery for acoustic neuroma today, the apollo speciality hospital, chennai, India uses up-to-date research, technologically advanced technologies, and has professional physicians to deliver this revolutionary cyberknife treatment method for effective treatment of the acoustic neuroma.
To know more about cyberknife treatment you may blog your comments or write to lakshmipriya_b@apollohospitals.com
SUCCESSFUL AVM TREATMENT WITH CYBERKNIFE
SUCEESSFUL TREATMENT OF 19 YEAR OLD WITH AVM USING CYBERKNIFE
CASE HISTORY: This 19 years old college student presented with the complaints of acute onset headache, right hemiparesis and right hemianopia. MRI revealed haemorrhagic infart in left inferior thalamus extending to capsule and old left posterior capsular infart. DSA revealed left temporal AVM (feeder Medial lenticulostride branches of Left MCA draining into vein of galen through basal vein. On examination patient had right hemianopia. Patient underwent treatment with cyber knife radio surgery on 22.6.2009. Patient is on regular follow up with Volume analysis which showed good regression of nidus. January 2011 CT angio revealed complete resolution of AVM. Patient’s vision has dramatically improved.
This 19 year old girl is now 21 years, she is also entering into married life soon. We wish her a very happy married life.
DOCTOR NAME: DR. RATHNA DEVI SR. CONSULTANT RADIATION ONCOLOGIST & CYBERKNIFE SERVICES
For more information you may blog your comments or write to lakshmipriya_b@apollohospitals.com
CASE HISTORY: This 19 years old college student presented with the complaints of acute onset headache, right hemiparesis and right hemianopia. MRI revealed haemorrhagic infart in left inferior thalamus extending to capsule and old left posterior capsular infart. DSA revealed left temporal AVM (feeder Medial lenticulostride branches of Left MCA draining into vein of galen through basal vein. On examination patient had right hemianopia. Patient underwent treatment with cyber knife radio surgery on 22.6.2009. Patient is on regular follow up with Volume analysis which showed good regression of nidus. January 2011 CT angio revealed complete resolution of AVM. Patient’s vision has dramatically improved.
This 19 year old girl is now 21 years, she is also entering into married life soon. We wish her a very happy married life.
DOCTOR NAME: DR. RATHNA DEVI SR. CONSULTANT RADIATION ONCOLOGIST & CYBERKNIFE SERVICES
For more information you may blog your comments or write to lakshmipriya_b@apollohospitals.com
Tuesday, June 8, 2010
Breast Carcinoma with Lung Metastasis
Breast Carcinoma with Lung Metastasis
Case History
A 44-year-old female diagnosed with carcinoma of the left breast in the year 2004 and was treated with mastectomy, chemotherapy and
radiation therapy was brought to Apollo Speciality Cancer Hospital. The patient was on hormonal therapy.
In the year 2006, the patient developed carcinoma of the contralateral breast (left) and had undergone surgery, followed by chemotherapy and radiation therapy to the left chest wall.
A PET scan was done in 2009. The scan revealed solitary metastasis in the lower lobe of the right lung. Owing to this, the patient was planned for CyberKnife® treatment. The patient was treated with 45Gy radiation dosage in three fractions to the lung lesion and had tolerated the treatment well. Complete response was seen in 3-month post-CyberKnife® follow-up scan
Discussion
Radiation therapy or surgery are frequently advised especially if chemotherapy is less efficient for patients suffering from single-lung metastasis.
However, as the lung mass moves with respiration, it is difficult to perform radiation therapy. Only respiratory-gated radiation therapy techniques deliver appropriate dose to the target and spare normal lung tissue. CyberKnife® has one of the most efficient respiratory tracking mechanisms (Synchrony) and this technology makes ‘real-time’ tracking possible by providing correct radiation dose to the tumour and avoiding the normal tissue in the vicinity. In addition, ‘See and Shoot’ technology in CyberKnife® helps to verify the target position prior to each treatment delivery and is the most accurate ‘online’ gated radiation therapy technique.
Doctor’s Comment
‘CyberKnife® is a fantastic option of providing the radiation therapy to the tumours which are mobile, like the one in this case. It avoids radiation exposure to normal tissue to a great extent.’
Dr. A. N. Vaidhyswaran
Patient’s Comment
‘I thought the treatment would be difficult, but the doctors at Apollo reassured me and they were true. The treatment was absolutely painless and I could go home immediately after the treatment’.
For more information on Cyberknife treatment you can blog your comments or write to lakshmipriya_b@apollohospitals.com
Case History
A 44-year-old female diagnosed with carcinoma of the left breast in the year 2004 and was treated with mastectomy, chemotherapy and
radiation therapy was brought to Apollo Speciality Cancer Hospital. The patient was on hormonal therapy.
In the year 2006, the patient developed carcinoma of the contralateral breast (left) and had undergone surgery, followed by chemotherapy and radiation therapy to the left chest wall.
A PET scan was done in 2009. The scan revealed solitary metastasis in the lower lobe of the right lung. Owing to this, the patient was planned for CyberKnife® treatment. The patient was treated with 45Gy radiation dosage in three fractions to the lung lesion and had tolerated the treatment well. Complete response was seen in 3-month post-CyberKnife® follow-up scan
Discussion
Radiation therapy or surgery are frequently advised especially if chemotherapy is less efficient for patients suffering from single-lung metastasis.
However, as the lung mass moves with respiration, it is difficult to perform radiation therapy. Only respiratory-gated radiation therapy techniques deliver appropriate dose to the target and spare normal lung tissue. CyberKnife® has one of the most efficient respiratory tracking mechanisms (Synchrony) and this technology makes ‘real-time’ tracking possible by providing correct radiation dose to the tumour and avoiding the normal tissue in the vicinity. In addition, ‘See and Shoot’ technology in CyberKnife® helps to verify the target position prior to each treatment delivery and is the most accurate ‘online’ gated radiation therapy technique.
Doctor’s Comment
‘CyberKnife® is a fantastic option of providing the radiation therapy to the tumours which are mobile, like the one in this case. It avoids radiation exposure to normal tissue to a great extent.’
Dr. A. N. Vaidhyswaran
Patient’s Comment
‘I thought the treatment would be difficult, but the doctors at Apollo reassured me and they were true. The treatment was absolutely painless and I could go home immediately after the treatment’.
For more information on Cyberknife treatment you can blog your comments or write to lakshmipriya_b@apollohospitals.com
Wednesday, January 20, 2010
LIVER METASTASES TREATMENT
Stereotactic body radiation therapy for liver metastases
O Dawood, A Mahadevan, K Goodman ,European J Cancer 2009;45:2947-2959.
This review focuses on stereotactic body radiation therapy (SBRT) as an alternative, non-invasive approach to the treatment of liver metastases. Treatment considerations of SBRT for liver metastases are presented with particular emphasis on the challenges of organ motion and the low tolerance of the surrounding hepatic parenchyma. Multiple approaches to tumor motion are discussed, including tumor tracking versus motion-compensation techniques. Issues of patient eligibility criteria, patient set-up, target definition, treatment dosimetry and fractionation are also discussed. Clinical results to date from 15 published reports, including a summary of the latest in-press results from Stanford using the CyberKnife System, are presented. These clinical reports demonstrate the safety and efficacy of SBRT for liver metastasis with 18-month and 2-year local control rates ranging from 71-93% and 71-86%, respectively.
The review concludes by stressing the importance of addressing hepatic tumor motion to ensure the dose reaches the tumor and spares the surrounding normal tissue. The authors suggest more rigorous phase II clinical studies are necessary to establish the long-term durability of efficacy and toxicity results.
SOURCE : FOCUS NEWSLETTER - JAN 2010
O Dawood, A Mahadevan, K Goodman ,European J Cancer 2009;45:2947-2959.
This review focuses on stereotactic body radiation therapy (SBRT) as an alternative, non-invasive approach to the treatment of liver metastases. Treatment considerations of SBRT for liver metastases are presented with particular emphasis on the challenges of organ motion and the low tolerance of the surrounding hepatic parenchyma. Multiple approaches to tumor motion are discussed, including tumor tracking versus motion-compensation techniques. Issues of patient eligibility criteria, patient set-up, target definition, treatment dosimetry and fractionation are also discussed. Clinical results to date from 15 published reports, including a summary of the latest in-press results from Stanford using the CyberKnife System, are presented. These clinical reports demonstrate the safety and efficacy of SBRT for liver metastasis with 18-month and 2-year local control rates ranging from 71-93% and 71-86%, respectively.
The review concludes by stressing the importance of addressing hepatic tumor motion to ensure the dose reaches the tumor and spares the surrounding normal tissue. The authors suggest more rigorous phase II clinical studies are necessary to establish the long-term durability of efficacy and toxicity results.
SOURCE : FOCUS NEWSLETTER - JAN 2010
Monday, November 23, 2009
DR. SURESH H.ADVANI at APOLLO SPECIALITY CANCER HOSPITAL - CYBERKNIFE CENTER.
Padma Bhushan Prof.(Dr.) Suresh H.Advani , a well known renowned specialist in Oncology visited Apollo Speciality Cancer Hospital recently.
He visited our Cyberknife facility and during a recent interview to" News Today "had the following to say :
‘I used to refer cancer patients to Malaysia where the CyberKnife procedure was available and now Apollo Hospitals, Chennai, has acquired the latest Asia Pacific’s most advanced CyberKnife robotic radiosurgery system, PET scanning, MRI, Radiography, bone marrow transplant unit which is to be set up at the earliest, with expertise in the field, all under one roof that makes Chennai city the medical destination,’ said Dr Suresh Advani
To read the interview with dr. Suresh H,Advanui please log on to www.newstodaynet.com Monday, 23 November, 2009
It was our previlige to have him here and get his valued opinion
FOR FURTHER INFORMATION ON CYBERKNIFE TREATMENT,PLEASE BLOG YOUR COMMENTS OR WRITE TO lakshmipriya_b@apollohospitals.com
He visited our Cyberknife facility and during a recent interview to" News Today "had the following to say :
‘I used to refer cancer patients to Malaysia where the CyberKnife procedure was available and now Apollo Hospitals, Chennai, has acquired the latest Asia Pacific’s most advanced CyberKnife robotic radiosurgery system, PET scanning, MRI, Radiography, bone marrow transplant unit which is to be set up at the earliest, with expertise in the field, all under one roof that makes Chennai city the medical destination,’ said Dr Suresh Advani
To read the interview with dr. Suresh H,Advanui please log on to www.newstodaynet.com Monday, 23 November, 2009
It was our previlige to have him here and get his valued opinion
DR.ADVANI in the center, with the cyberknife panel of radiation oncologits at Apollo Speciality Cancer Hospital .
FOR FURTHER INFORMATION ON CYBERKNIFE TREATMENT,PLEASE BLOG YOUR COMMENTS OR WRITE TO lakshmipriya_b@apollohospitals.com
Thursday, November 19, 2009
CYBERKNIFE SUCCESS STORY FEATURED IN "THE WEEK" magazine
The 1st Cyberknife Success Story , featured in " The Week " Nov 15 edition on Week-IMRB exclusive survey on Best Hospitals 2009.
The Success story of Master Sanka Subradey , aged 15 from Tripura was the 1st Patient in India to undergo Cyberknife Treatment at Apollo Speciality Cancer Hospital, Chennai.
Post treatment , the follow up in September 09 showed in MRI significant reduction in tumour size & he is back to normal life busy preparing for his Class X board examination , thanks to Robotic Radiosurgery system like Apollo Cyberknife
FOR MORE INFORMATION ON TREATMENT PLEASE WRITE TO lakshmipriya_b@apollohospitals.com
Thursday, November 5, 2009
TRIGEMINAL NEURALGIA
CYBERKNIFE IN TREATMENT OF TRIGEMINAL NEURALGIA
Dr.M.Balamurugan, Senior Consultant - Neuro Surgery
"The Suicide Disease" or tic douloureux(also known as prosopalgia) is a neuropathic disorder of the facial trigeminal nerve. The trigeminal nerve the fifth cranial nerve, is responsible for sensory data (pressure, tempereature & pain) and also responsible for the motor function of the muscles involved in chewing but not facial expression.
SYMPTOMS
The disorder is characterised by episodes of intense facial pain that usually last from a few seconds to several minutes or hours. The attacks are said to feel like stabbing electric shocks, burning, pressing, crushing, exploding or shooting pain that becomes intractable.
Unfortunately, the symptoms of trigeminal neuralgia are often falsely attributed to a pathology of dental origin. Because of this difficulty, many patients go untreated unless a correct diagnosis is made.
There is evidence that points towards the need to quickly treat and diagnose TN. It is thought that the longer a patient suffers from TN, the harder it may be to reverse the neural pathways associated with the pain. Therefore it is essential that physicians are made aware of the seriousness of TN and the level of pain that their patient
TREATMENT OPTIONS
Medical treatment may involve usage of Anticonvulsants such as carbamazepine, oxcarbazepine, topiramate, phenytoin, or gabapentin and sometimes low doses of some antidepressants such as amytriptiline is used.
Surgically there are five options available . Of the five surgical options, the microvascular decompression is the only one aimed at fixing the presumed cause of the pain. Three other procedures use needles or catheters that enter through the face into the opening where the nerve first splits into its three divisions. Excellent success rates using a cost effective percutaneous surgical procedure known as balloon compression are available. This technique has been helpful in treating the elderly for whom surgery may not be an option due to coexisting health conditions. Balloon compression is also the best choice for patients who have ophthalmic nerve pain or have experienced recurrent pain after microvascular decompression.
Other options involve using glycerol injections and radiofrequency rhizotomies. Glycerol injections involve injecting an alcohol-like substance into the cavern that bathes the nerve near its junction. This liquid is corrosive to the nerve fibers and can mildly injure the nerve enough to hinder the errant pain signals. In a radiofrequency rhizotomy, the surgeon uses an electrode to heat the selected division or divisions of the nerve. Done well, this procedure can target the exact regions of the errant pain triggers and disable them with minimal numbness.
Stereotactic Radio Surgery The nerve can also be damaged to prevent pain signal transmission using Gamma Knife or a linear accelerator-based radiation therapy (e.g. Trilogy, Novalis, CyberKnife).
Cyberknife Radiosurgery : Of these, the development of CyberKnife radiosurgery (Accuray, Inc., Sunnyvale, CA) in 1994 added a promising new treatment option for this disease. Using noninvasive head immobilization and advanced image-guidance technology, the CyberKnife dynamically tracks skull position and orientation during treatment, thereby ensuring targeting accuracy throughout the entire procedure, and patients are spared the discomfort of frame fixation onto their skulls. CyberKnife radiosurgery offers the ability to deliver nonisocentric, conformal and homogeneous radiation doses to nonspherical structures such as the trigeminal nerve. There are no risks of infection, cerebrospinal fluid leak or wound healing from Cyberknife Radiosurgery. However, some patients may develop additional numbness in the face or may experience abnormal facial sensations. This occurs in less than 10% of patients.
For more information please write to : lakshmipriya_b@apollohospitals.com;
Dr.M.Balamurugan, Senior Consultant - Neuro Surgery
"The Suicide Disease" or tic douloureux(also known as prosopalgia) is a neuropathic disorder of the facial trigeminal nerve. The trigeminal nerve the fifth cranial nerve, is responsible for sensory data (pressure, tempereature & pain) and also responsible for the motor function of the muscles involved in chewing but not facial expression.
SYMPTOMS
The disorder is characterised by episodes of intense facial pain that usually last from a few seconds to several minutes or hours. The attacks are said to feel like stabbing electric shocks, burning, pressing, crushing, exploding or shooting pain that becomes intractable.
Unfortunately, the symptoms of trigeminal neuralgia are often falsely attributed to a pathology of dental origin. Because of this difficulty, many patients go untreated unless a correct diagnosis is made.
There is evidence that points towards the need to quickly treat and diagnose TN. It is thought that the longer a patient suffers from TN, the harder it may be to reverse the neural pathways associated with the pain. Therefore it is essential that physicians are made aware of the seriousness of TN and the level of pain that their patient
TREATMENT OPTIONS
Medical treatment may involve usage of Anticonvulsants such as carbamazepine, oxcarbazepine, topiramate, phenytoin, or gabapentin and sometimes low doses of some antidepressants such as amytriptiline is used.
Surgically there are five options available . Of the five surgical options, the microvascular decompression is the only one aimed at fixing the presumed cause of the pain. Three other procedures use needles or catheters that enter through the face into the opening where the nerve first splits into its three divisions. Excellent success rates using a cost effective percutaneous surgical procedure known as balloon compression are available. This technique has been helpful in treating the elderly for whom surgery may not be an option due to coexisting health conditions. Balloon compression is also the best choice for patients who have ophthalmic nerve pain or have experienced recurrent pain after microvascular decompression.
Other options involve using glycerol injections and radiofrequency rhizotomies. Glycerol injections involve injecting an alcohol-like substance into the cavern that bathes the nerve near its junction. This liquid is corrosive to the nerve fibers and can mildly injure the nerve enough to hinder the errant pain signals. In a radiofrequency rhizotomy, the surgeon uses an electrode to heat the selected division or divisions of the nerve. Done well, this procedure can target the exact regions of the errant pain triggers and disable them with minimal numbness.
Stereotactic Radio Surgery The nerve can also be damaged to prevent pain signal transmission using Gamma Knife or a linear accelerator-based radiation therapy (e.g. Trilogy, Novalis, CyberKnife).
Cyberknife Radiosurgery : Of these, the development of CyberKnife radiosurgery (Accuray, Inc., Sunnyvale, CA) in 1994 added a promising new treatment option for this disease. Using noninvasive head immobilization and advanced image-guidance technology, the CyberKnife dynamically tracks skull position and orientation during treatment, thereby ensuring targeting accuracy throughout the entire procedure, and patients are spared the discomfort of frame fixation onto their skulls. CyberKnife radiosurgery offers the ability to deliver nonisocentric, conformal and homogeneous radiation doses to nonspherical structures such as the trigeminal nerve. There are no risks of infection, cerebrospinal fluid leak or wound healing from Cyberknife Radiosurgery. However, some patients may develop additional numbness in the face or may experience abnormal facial sensations. This occurs in less than 10% of patients.
For more information please write to : lakshmipriya_b@apollohospitals.com;
Wednesday, May 27, 2009
ACCURAY PRESS RELEASE ON THE FIRST CYBERKNIFE TREATMENT IN INDIA
First Patients Treated in India Using CyberKnife Radiosurgery
Newly Installed System at Apollo Hospital Treats Six and Preps Eight Patients in First Week
SUNNYVALE, Calif., April 3, 2009
Newly Installed System at Apollo Hospital Treats Six and Preps Eight Patients in First Week
SUNNYVALE, Calif., April 3, 2009
To read more .... log on to http://www.accuray.com/; http://www.accuray.com/Content.aspx?id=2406&terms=india
Source: Accuray Inc
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