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Hearing Preservation

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bpham:
When I talked to Dr. Friedman at HEI and he saw my audiologist's report on my left side hearing was tested at 65db of only 12% usable hearing, he immediately said that my hearing on that ear is very bad and therefore he recommended the Trans-lab surgical option. 

He also indicated that the hearing nerve is very fragile not like the facial nerve which can recover, therefore, it is not necessary to save the hearing on that ear and hence recommending the Trans-lab.

My question is, had anyone that had pretty bad hearing like mine now, went with the other surgical options (mid-fossa and RS) and recovered the hearing back to a useful state?

Basically my hearing test results are:

The results with Air Conditioning Mask:

Hz       db
------    ------
250     50
500     50
1000   30
2000   10
4000   50
8000   30

The results without Air Conditioning Mask:

Hz        db
-------    ------
250      50
350      35
500      50
750      25
1000    20
2000    10
3000    40
4000    45
6000    30
8000    30

Normal results should be 250hz to 8000hz within 0-20db.

For me, when I closed the good ear totally, and my wife spoke to me from 5 feet away, I can barely understand her.  Most cases, when I watch TV from 10 Ft away, with my good ear closed, I could not make out any intelligent word at all except some broken noise.

Will the hearing get better or stayed the same in most cases after mid-fossa or RS methods?

Thanks.

Mark:
Bpham,

It is very rare for hearing to get better after either surgery or radiation, and if so only by a small measure. In most cases there will be some additional decline. I'm not qualified to evaluate your audiogram scores but if the 12% number is for speech recognition when amplified, then I would agree with Dr. Friedman's characterization. Most surgeons seem to feel that the translab exposes the facial nerve better during ressection than the other two. I think he is making a judgment that there is little opportunity to save your hearing and he is opting for the route that gives him the best option to preserve facial nerve function which I think most everyone here would agree is the most critical aspect.

Also, I'm curious, did you ever talk with Dr. Chang at Stanford for his opinion? I may have missed a post somewhere along the line.

Mark

tony:
Yes - sadley I would agree - 12% really is not very much
at that stage  were the sound to be distorted (post surgery/radiation swelling)
it might impact on the good side as well - by confusing the issue
I think you may have some difficult choices to make
By all means get another opinion - any one tell you he can
restore to normal or 75% even - best to drop us a note ?
On a brighter note - once I lost the bad side
I did understand better - the distortion had gone
best regards
tony

sgerrard:
I am sorry to hear that news, Bpham. I have not come across any case of someone recovering usable hearing from that low a level. I can't read the audiogram either, but based on your description of closing the good ear, your hearing is pretty far gone on the AN side. That would indicate that the AN is tangled up with the hearing nerve, making it nearly impossible to remove the tumor without also taking out the nerve. Radiation might save some of what you have left, but you won't get any more back.

I think trans-lab is considered the least invasive surgery approach, because it does not involve any brain retraction, while both MF and RS do. That also usually makes it the shortest procedure, with the simplest recovery. It is a natural choice when the AN has already damaged the balance and hearing nerves on that side.

I agree with Mark, if you haven't already, you should at least email Dr. Chang, and mail him a CD of your MRI and your audiogram test if you can. He could tell you best whether radiation with CK has anything to offer, or he might agree that trans-lab surgery is the best choice in your case, since he does both radiation and surgery.

Oh well. You will still hear, you will still smile, and your wife will still love you. There is still plenty of life ahead for you.

Steve

bpham:
Thanks for all the encouraging words.  That was what my wife told me...I still have her and the kids...not bad.

I've emailed and sent my MRI's to DR. Chang last week and he should have received it last Tuesday 9/4.  However, I've sent him 3 emails after that but no reply.  I think that either he is busy and has not had the chance to look over the pictures yet.  I'm trying to get a second opinion from UCLA.

At this stage since my facial nerve has already been bothered (twitching, spasm, etc..) I'm leaning heavily into the Trans-lab option, unless there was a significant difference when Dr. Friedman has carefully reviewed the films with his colleagues and found something else than he initially saw in my first visit.

He wants me back for a more focus CT scan to look at the area more closely and then I'll have another meeting with both him and Dr. Schwartz, the Neurologist and discuss the case.

I guess when Tony said the hearing on the good side will be better, I believe him since at this time the bad site has lots of distorted noise and sound and tinnitus.  What about tinnitus, after the Translab, will it go away?

What about with 12% hearing, if they can preserve it, can I use hearing aid and be useful with that ear?

Thanks.

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