- Main options for meningioma removal
- Stereotactic radiosurgery
- Advantages and disadvantages of meningioma removal with the help of the GammaKnife
- Features of meningioma resection with CyberKnife
- Peculiarities of stereotactic radiosurgery using the TrueBeam system
- Surgical treatment of meningioma
- Rehabilitation after removal of meningioma
Anadolu Medical Center is a combination of Turkish affordability and geographical proximity with US quality of treatment due to affiliation with Johns Hopkins Medicine. This Clinic specializes in oncology treatment and bone marrow transplants using the most innovative equipment: DaVinci, CyberKnife, TrueBeam. Anadolu Hospital is very attentive to each patient and has the highest level of staff response.
Sourasky Medical Center (Ichilov) is a leading Israeli clinic located in the center of Tel Aviv. It unites 5 hospitals, 180 polyclinics, and 60 departments are located. The Ichilov (Tel Aviv) has got an accreditation from the Joint Commission International (JCI) global organization for quality and safety of medical service. It belongs to TOP-10 world destinations for medical tourism according to the authoritative Newsweek magazine.
Solingen Municipal Hospital/Academic Hospital of the University of Cologne is among top clinics in Germany according to Focus magazine - one of the most widely circulated German editions. Städtisches Klinikum Solingen is a certified medical institution treating over 60,000 patients per year.
Removal of meningioma is the main method of treating benign or malignant meningiomas. Most of the experts use radical surgery or radiation therapy to remove meningiomas.
Meningioma resection is divided into:
- total (whole tumor is removed);
- subtotal or partial (only a part of tumor is removed).
Main options of meningioma treatment
The type of therapy depends on the size of the tumor, its location, the age of a patient and the presence of pathologies.
There are 2 main methods of meningioma treatment:
- Stereotactic radiosurgery used for difficult access to the tumor and close connection of meningioma with vessels, nerve trunks, sinuses of the brain;
- Surgical removal used in cases of the big size of meningioma (more than 3.5cm in diameter).
Radiosurgery is a medical procedure used for destroying of tumors or suspending their functioning by means of a single irradiation with a high dose of ionizing radiation.
Radiosurgery has two main advantages:
- Irradiation affects the meningioma from different directions (tumor receives the maximum possible dose of radiation)
- Radiosurgery is non-invasive (treatment of a tumor does not require breaking the integrity of the head tissue and opening the cranium).
The contraindication for radiosurgery is the inability to operate brain tumors over 3.5 cm in diameter. The effectiveness of stereotactic radiosurgery is very high: about 95% of meningiomas stop their growth after a single procedure or a small course of treatment.
The main radiotherapeutic / radiosurgical units are:
- designed for non-invasive brain surgery (without the use of a scalpel);
- has a frame based system for immobilization with radiation sources, which can causeside such effects of gamma knife surgery for meningioma as headache, nausea and a risk of infection;
- one image of magnetic resonance imaging is used, in contrast to systems that do not use a frame for attaching the head and require constant imaging with CT during treatment, making an additional contribution to excess radiation doses;
- small sizes of collimators protect the body tissues from the effects of radiation and excludes the possibility of treatment of metastases and tumors over 3 cm.
- universal method not only for treating the brain, but also for removing the tumor and metastasis throughout the body;
- mega-voltage X-ray radiation from the CyberKnife is four times more powerful than the energy from cobalt used in the GammaKnife;
- CyberKnife is a flexible, frameless system that allows a patient to conduct treatment in one or more sessions. This allows oncologists to choose the safest and most effective course of treatment;
- does not require a frame screwing into the skull for immobilization, which helps to avoid headache, nausea and the risk of infection.
Peculiarities of stereotactic radiosurgery using the TrueBeam system
- Focused radiation beams of the system destroy tumor cells without affecting the surrounding healthy tissues;
- use of a metal frame that is bolted to the skull bones of a patient is unnecessary;
- opportunity of fractional irradiation (treatment is divided into 2-5 small sessions, which makes possible to safely treat large meningiomas located near important structures, for example, the optic nerve);
- TrueBeam system is equipped with modern medical imaging devices that allow a radiologist to monitor the tumor behavior in real time;
- During visualization of pathological formations, the technology of cone-beam computed tomography (CT) is used. This method of visualization makes possible to reduce the radiation load on the patient's body by 25%.
Surgical treatment of meningiom
There are 2 indications for surgical removal of meningioma:
- If the tumor is in the area of the brain that is available for surgery
- If the tumor over 3.5 cm in diameter.
Endoscopic intervention is the minimally invasive method of meningioma removal, when the tumor is removed without opening the skull with endoscopic instruments. Removal of meningioma through transnasal access is most often used. The method is the most effective in combination with intraoperative MRI and nerve navigation systems.
Craniotomy or trepanation of the skull is carried out only if the tumor is located close to the surface. This method provides good visibility of the operating field and allows the removal of large tumors.
Preparing for the operation
For the accurate determination of the type of meningioma and for prescribing the fastest and most effective treatment, a patient should go through the following procedures:
- Blood test;
- MRI - magnetic resonance imaging;
- MRS - magnetic resonance spectroscopy;
- CT - computed tomography;
Rehabilitation after removal of meningioma
The rehabilitation period can range from few weeks to a year. It depends on the method of treatment and the type of operation. The physical and psychological condition of a patient before surgery also affects the postoperative period. The recovery will occur quickly if a patient follows a doctor's prescribed rehabilitation program and takes the necessary medicines.
Consequences after meningioma removal
Consequences after the removal of meningioma depend on tumor localization, prevalence of pathological process and histologic type. Young people have none of consequences after meningioma resection in contrast to elderly patients, who face negative effects much more often.
Consequences after resection of meningioma can be various:
- loss of sight;
- hearing loss;
- sensitivity depression;
- paralysis of extremities;
- lacks of coordination;
Recurrence of meningioma after removal
Meningioma recurrence rate after the operation:
- 3% for benign tumors;
- 38% for atypical tumors;
- 78% for malignant tumors.
Also possibility of meningioma recurrence depends on location of a tumor.
- at the cranial vault is 3%;
- in the region of the Turkish saddle is 19%;
- in the region of the body of the sphenoid bone 34% within five years;
- in the cavernous sinus is 60-100%.
Helios Berlin-Buch is the largest and modern hospital in the capital of Germany.
It is included in the best German centers list in 2018 according to the Focus magazine ranking.
94% of patients recommend Helios Berlin-Buch for diagnostics and treatment.
Key specialties of the hospital are oncology and surgical oncology, orthopedics, neurosurgery, and obesity treatment.
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Epileptology (treatment of epilepsy), neurosurgery, oncology, heart surgery, and stem cell therapy are the primary specialties in Teknon Hospital.
Teknon Hospital is No.1 choice of celebrities, sportsmen, and politicians. Teknon doctors delivered Shakira's baby (famous singer), operated Andres Iniesta (Spanish professional footballer), Thomas Röhler (German athlete competed in the javelin throw), provided stem cell therapy for Rafael Nadal (Spanish professional tennis player) and FC Barcelona football players.
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Over 600 highly-qualified doctors from Russia, France, the USA, Israel, Germany and Japan work at EMC. Among them are 16 professors and over 30 doctors of medical science.
Memorial Şişli Hospital in Istanbul is the largest multidisciplinary medical center in Istanbul. It is the 1st hospital in Turkeу and the 21st in the world accredited by Joint Commission International (JCI) for the high quality of treatment.
Memorial Şişli specialties are the following: oncology, bone marrow transplant, in vitro fertilization (IVF), neurosurgery, and organ transplant. The success rate of organ transplant at Memorial is 90%.
Patients from 92 countries choose Memorial Şişli for treatment annually.
Bumrungrad International Hospital is a global medical facility in Bangkok, Thailand that specializes in oncology, ophthalmology, orthopedics, neurosciences, heart surgery, check-ups, etc.
Over 1 million patients choose Bumrungrad annually. 50% of them are international ones from over 190 countries.
The hospital is one of the largest private centers in Southeast Asia and one of the most significant world’s outpatient clinics.
Bumrungrad International is recognized as TOP-10 best hospitals and TOP-30 most technologically advanced clinics in the world.
Medical Park is the largest group of hospitals in Turkey. Compliance of their medical services is confirmed by Joint Commission International. Medical Park Hospitals are ranked first in the number of organ transplants and provide high success rates in bone marrow transplantation. Oncological units use innovative techniques to increase efficiency of the treatment - Gamma-Knife, the Tomotherapy etc.
Helios Krefeld Hospital is a multidisciplinary center in Germany, one of the most modern facilities in Europe. Since 2015 to 2017, it took the leading positions among top hospitals of Germany according to the Focus magazine ranking.
Specialties of the hospital are surgery, oncology, heart surgery, orthopedics. Over 57,500 patients choose Helios Krefeld for treatment. According to the anonymous survey, 95% of patients are satisfied with the diagnostics and treatment.
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Clinica Universidad de Navarra (CUN) cooperates with the University of Navarra and the Center for Applied Medical Research (CIMA). Navarra Hospital is represented by 35 medical units and 10 specialized multidisciplinary departments, each of which is equipped with cutting-edge technologies. The Clinic has been certified by JCI (Joint Commission International) since 2004 and accredited by ESMO (European Society for Medical Oncology) as the Center of Excellence in the field of oncology and palliative therapy. Hospital de Navarra focuses on international patients providing them with all necessary assistance. Over 700,000 patients worldwide have already entrusted their health to this Clinic.
Asklepios St. Georg Hospital is a multidisciplinary medical center in Hamburg. The Hospital works on the premisses of Asklepios Kliniken Medical Group.
The Hospital specializes in the treatment of the heart, vessels, and spine diseases.
St. Georg Hospital is among the TOP German medical facilities according to the Focus magazine.
87,000 patients receive the treatment annually here.
Global Hospital (Gleneagles Global Health City) is a multidisciplinary hospital in Chennai, India.
The hospital is the best medical facility for the organ transplant in the country and the world’s leader in the number of successful liver transplants (over 1,000). Doctors are the 1st in India to perform minimally invasive lung and combined heart-kidney transplants.
Gleneagles Global Health City specializes in the organ and bone marrow transplant, cardiology, pulmonology (treatment of the lungs), and oncology.
Global Hospital Chennai is a part of Gleneagles Global Hospitals Medical Group, which accepts 2 mln patients annually.
Ospedale San Raffaele is a University Hospital of world importance which conducts a clinical researches and applies specialized methods for treatment of serious diseases in the field of oncology, oncohematology and surgery. Ospedale Hospital is recognized by the Ministry of Health as an Institute of Hospitality and Care specialized in Molecular Medicine.The main feature of the Clinic is a practical use of molecular biology for treatment metabolic, immune, infectious, genetic pathologies, illnesses of central and peripheral nervous system.
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Ewha Womans University Medical Center (EUMC) is the first and best hospitals for women in Korea, which is located in the western part of Seoul is 45 km from Incheon International Airport and 10 km from Gimpo Airport.
BGS Global Hospital is a private multidisciplinary hospital in Bangalore, India, specialized in oncology, neurosurgery, and hepatology. For cancer treatment, this hospital uses the last version of radiotherapy equipment, such as TrueBeam STx that accurately irradiates a tumor even in hard-to-reach areas.
Annually, Global Hospital Bengaluru gives treatment for over 53,000 patients. Doctors of this hospital have performed more than 30,000 operations.