Dr Aditya Gupta
Acoustic neuroma can be treated with cyberknife radiosurgeryAcoustic neuroma can be treated with cyberknife radiosurgery
What is Acoustic Neuroma?
Acoustic Neuroma which is also known as vestibular schwannoma, is a benign tumour which is non-cancerous and usually grows slowly. It develops on the main nerve that leads from the inner ear to the brain. The branches of this nerve influence the balance, hearing and the pressure from an acoustic neuroma that can cause hearing loss, ringing in your ear and unsteadiness.
The symptoms start with the gradual loss of hearing in one ear and the problem is accompanied by the ringing in the ear also with the feeling of fullness in the ear. The acoustic neuromas can cause the sudden hearing loss.
The symptoms that occur over time include
2. Facial numbness and tingling
3. Problem with balance
4. Facial weakness
5. Change in taste
6. Difficulty in swallowing
9. Mental confusion
Cyberknife radiosurgery has revolutionised the treatment of Acoustic Neuroma.
The cause of the development of acoustic neuroma is unknown. A rare hereditary disease ‘Neurofibromatosis’ is associated with acoustic neuroma.
It can also be caused by
1. Continuous exposure to loud noise
2. Radiation on face and neck can lead to acoustic neuroma many years later.
In 1 out of 10 people, an acoustic neuroma is caused by neurofibromatosis type-2 (NF2). NF2 can run in further generations also. A person suffering from NF2 can develop benign tumours on the spinal cord and the coverings of the brain. Acoustic neuromas formed through the type of cells called a schwann cell. These cells cover the nerve cells of the body. That’s why this tumour is also called vestibular schwannoma.
An acoustic tumour grows with the nerve in the brain. This nerve is called cranial nerves or the acoustic or vestibulocochlear nerve. This nerve is responsible to control the sense of hearing and also the balance of the body. An acoustic tumour is rare and in between 1 and 20 people in every million worldwide are diagnosed each year with an acoustic neuroma. And it’s more common in women than men.
Acoustic neuroma treated with Cyberknife
Surveys say that two out of 100,000 people aged 30 to 60 develop acoustic neuroma, which makes this condition incredibly rare. The treatment depends on the size of a tumour. If a tumour is large, there will be more medical problems. The small size of a tumour is less than 1.5 cm, the medium is between 1.5 cm and 2.5 cm and large is 2.5 cm or larger. Small tumours require Cyberknife due to their size while the larger tumours typically require surgery.
The newest radiation therapy option for acoustic neuroma is a form of radio surgery that requires absolutely no incisions using a new technology called Cyberknife. Patients treated with this new non-invasive experience minimal to no side effects. Radio surgery techniques can stop tumours from growing by using high-dose exact precision radiation treatment. Patients treated by Cyberknife technology experience minimal to no side effects and receive treatment on an out-patient basis. After patients undergo radio surgery, the acoustic neuroma is closely monitored to confirm the growth has stopped or that a tumour has begun to shrink.
The surgery includes advanced robotics, tumour tracking and imaging capabilities. The patients with particular symptoms like pressure symptoms or imbalance may be best treated with this surgery because surgery will relieve the symptoms more rapidly. Also, the large tumours mean the size greater than 3.0 cm are best treated with surgery because these tumours can sometimes swell and cause obstruction in the flow of cerebrospinal fluid.
Treatment starts with the CT scan. The CT scan image is then imported to the Cyberknife treatment planning system. The oncologist team plan to treat a tumour while avoiding surrounding important sensitive structures. The process involves several sittings and per sitting lasts for maximum 1 hour per sitting. The treatment does not require any sedation and is painless.
The chances of side effects are next to negligible. Hearing is preserved and achieved in 50-75% of the time. Temporary numbness of one side of the face is 2-3%. After the Cyberknife surgery tumours stabilise in size then shrink with time.
This winter control asthma with inhalation therapy
Whether youre indoors or outdoors, winter will exacerbate asthma attacks. Winter is the most loved season, but it might be unpleasant for patients with lung diseases. An American Lung Association fact-sheet states that asthma is one of the most common chronic disorders and currently affects about 7.1 million children under 18 years. The World Health Organisation Global Burden of Disease Study estimates that 13.8 million disability-adjusted life years (DALYs) are lost yearly due to asthma, representing 1.8 per cent of the total global disease burden.
For 300 million people around the globe suffering from asthma, the cold winter months often lead to a worsening of their symptoms.
The cold environment it not suitable for asthma patients. Their lungs and airway passages are quite sensitive. To a larger extent, asthma symptoms related to winter can be in controlled and managed by precise treatment and medication. Due to the swelling in the lining of the airways which leads to their narrowing, and the sticky mucus or phlegm build-up that blocks the airways, breathing is difficult and forced for asthmatic patients.
During winter, the cold air causes airways to tighten further, making it even more difficult to breathe.
Many patients and their family members are misinformed about the causes of asthma and the treatment options available. It is a necessity to educate patients and caregivers about the disease and treatment with minimal side-effects of inhaled corticosteroids, i.e. inhalation therapy.
Many pharmaceutical organisations are running campaigns to bust myths around inhalation therapy. Often, the word steroids evokes apprehensions in the minds of patients causing them to shy away from inhalers. The steroid is produced by the human body naturally to deal with inflammation and it is also safe for children and pregnant women. The inhalation therapy consists of an inhaler pump to send the corticosteroids into airway passages.
According to a research article published in Respiratory Medicine journal, the correlation between inhalation therapy for asthma and clinical efficacy is positive, with improved symptom-control and lung-function shown in most studies of adults, adolescents and children.
In the inhalation therapy, the inflammation of the airway requires a very small quantity of corticosteroids — around 25 to 100 micrograms — but when it is consumed through the oral/intestinal route the amount administered is very large — about 10,000 micrograms, since only a fraction of the drug reaches the lungs. This means that every time an asthma patient pops a pill or a tablet, he/she is actually taking almost 200 times the amount of medication required, leading to ill-effects on health.
Inhalation therapy directly gives body only that amount of steroid needed to control the symptoms. Against this, oral medication first gets dissolved in the blood and then reaches various organs, including the lungs.
Thus, inhalation therapy is a simple and easy solution for asthma patients to enjoy their winter to the fullest.
Some nose, throat bacteria less likely to develop into flu: Study
US researchers have identified a cluster of nose and throat bacteria that made their hosts less likely to get flu.
The researchers from the University of Michigan (UM) looked at samples of nose and throat bacteria and used DNA sequencing to identify which bacteria were present.
Analysing the bacterial composition across all samples, they found five clusters.After taking into account other known factors that could affect an individual’s
susceptibility to influenza, such as age, exposure to tobacco, crowded household and flu vaccination, the researchers then looked to see if individuals with a given cluster were less likely to get influenza.
“We looked at who had which cluster and whether it makes a difference on whether they got influenza, and it does,” said lead author Betsy Foxman, Professor at UM. “That’s the exciting thing about it. It tells us if you have this bacterial community, you have lower risk for getting the flu. That’s big news because it really hasn’t been shown before.”
However, the findings published in PLOS ONE journal also bring new questions.”Is it really possible to push someone’s microbiome in a way that would make a difference? Is it possible that we could tell people – ‘Here’s your microbiome pill?'” Foxman said, adding that “It’s a very long road and we’re at the beginning.”
Researchers hope that similar studies can be done in a different population and possibly follow them longer for secondary bacterial infections.”We know we are always going to need new antibiotics but this way we could hold on to them longer and, presumably, if we could intervene in this way there would be fewer side effects,” Foxman said.
For the study, the team enrolled 717 participants from 144 households. Household members of individuals with confirmed influenza were recruited for the study and followed for 13 days or until they developed influenza, whichever came first. They included only the 537 individuals who tested negative for influenza at the beginning of the study.
Taking artificial sweeteners as a sugar substitute? Study says it may not be effective
While some people who are trying to avoid sugar are increasingly opting for artificial sugar, a recent study has revealed that taking artificial sugar may not be a good idea after all.”Growing concerns about health and quality of life have encouraged people to adapt healthy lifestyles and avoid the consumption of food rich in sugars, salt, or fat to prevent obesity and other non-communicable diseases. With increased consumer interest in reducing energy intake, food products containing non-sugar sweeteners (NSSs) rather than simple sugars (monosaccharides and disaccharides) have become increasingly popular”, the study stated.
But replacing sugar with artificial sweeteners used in Diet Coke and other soft drinks has no effect on weight loss and their long-term health effects are still poorly understood, the review said. The study titled ‘Association between intake of non-sugar sweeteners and health outcomes: systematic review and meta-analyses of randomised and non-randomised controlled trials and observational studies’ was led by the University of Freiburg and published in the BMJ.
It also highlighted the absence of research on the long-term health effects of sweeteners when taken over years or decades. In this comprehensive systematic review, a broad range of health outcomes was investigated to determine a possible association with non-sugar sweetener used by a generally healthy population.
“The studies were set up to look at different types of sweeteners, measuring weight, blood sugar (glycaemic) control, oral health, cancer, cardiovascular disease, kidney disease, mood and behaviour in consumers. For most of them, there was no statistical difference in weight loss or health benefits of adults and children using higher doses of sweeteners rather than small amounts or none”, a report in The Guardian stated.
This comprehensive systematic review covers a broad range of benefits and harms of NSSs in a generally healthy population of adults and children, following rigorous systematic review methods. “Overall, we included 56 studies of adults and children, which assessed the associations and effects of NSSs on different health outcomes.
For most outcomes, there seemed to be no statistically or a clinically relevant difference between NSS intake versus no intake, or between different doses of NSSs. No evidence was seen for health benefits from NSSs and potential harms could not be excluded. The certainty of the included evidence ranged from very low to moderate, and our confidence in the reported effect estimates is accordingly limited”, the study stated.