Thanks for all your quick replies. How I wish the tumour was 3mm instead of 3cm. What if they forgot to put a decimal point between 33mm. The white giant spot glaring on my MRI films helped me pass the denial stage long ago.
Theoretically, enlarged translab approach provides excellent exposure of facial nerve. However, statistically, from published papers the percentages of facial nerve preservation between translab and retrosigmoid are almost the same. What concerned me most are various complications after surgery, which bring down quality of life.
In order to clear my mind and get inspired, I went mountain trekking with my friends this week. Lying under the stars, with the sound of rustling in the tree leaves, I suddenly realized that I shouldn’t just sacrifice my vestibulocochlear nerve without even trying. Retrosigmoid is the way to go. The only question now is which neurosurgeon I should choose.
Doc A:Neurosurgeon, 57-yr-old, has more than 20 years experience dealing with AN through Retrosigmoid. Total cases: about 700, 95% total resection, 96% anatomic preservation of the facial nerve, 86-90% functional preservation of the facial nerve.
Doc B:Neurosurgeon, 48-yr-old, has about 12 years experience of micro neurosurgical operation for tumours of the skull base. Not as experienced as the first neurosurgeon for AN operation. However, many fellow members confirmed that he was a top notch neurosurgeon with exceptional operation skills.
Doc C:ENT, 59-yr-old, who is familiar with both translab and retrosigmoid, has more than 20 years experience for AN surgery. Total cases: about 500, 95% total resection, 98% anatomic preservation of the facial nerve, 80-90% functional preservation of the facial nerve.
A, B, C which one will you choose?