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Which surgery is better for meningioma?

Q: I am a patient of left sphenoid wing meningioma en plaque which has extended medially to the cavernous sinus but not encasing any important nerves in sinus. Tumour is of moderate size and non-cancerous. I have been operated twice and the biopsy report shows that the tumour is not aggressive but grows really fast. Now after the second surgery I have lost my vision in the left eye completely, there is residual tumour which has to be remove using radiosurgery. But my surgeon is not able to remove it from the cavernous sinus. Which type of radio surgery is best suited for me considering the moderate size of the tumour which is spreading? If gamma knife is not possible is it better to go for x-knife or conventional SRT?

A:Both gamma knife and x- knife has a similar effectiveness and limitations. If size is the limiting factor, you may seriously have to consider a re surgery to reduce the size as far as possible. Conventional radiation is not too effective. The next mode of treatment is best discussed by the surgeon and the person giving the radiation.

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