Is the retrosigmoid approach the approach where they get in from the neck?

[catlover]

Hi everyone,
Since I live in Sweden we have different namnes of the approaches. I will have surgery in March-April 2009 and the doctors have planned an approach where you get in from the neck. Is it the approach you call the retrosigmoid approach? 

Catlover

[Syl]

Catlover,

I had retrosig surgery. The hole is drilled higher up than the neck. I can't tell exactly where mine is, but of the three approaches it is the lowest one. The middle fossa is up higher and the translab is through the ear canal.

What are the names given to the different approaches in Sweden?

Syl

[leapyrtwins]

Copped this from my doc's website - don't think he'd mind as it's all in the name of science.

Hope it helps.

Retrosigmoid Approach
In this approach, the bone is opened behind both the mastoid bone and the inner ear. In this way the tumor is removed from behind the inner ear. Retrosigmoid removal also allows the possibility of hearing preservation and may be used for both small and large tumors.

Jan

[catlover]

Hi,
Thanks Syl and Jan. I think it is the retrosigmoid approach that I'm going to have. I know the doctors have chosen this approach for me because of the possibility of preserving a bit of my hearing. Thanks both of you for the information.

In Sweden the doctors do three approaches. The translab is the most common and from time to time they also do the middle frossa and the one that you call retrosigmoid is called the suboccipal approach, or something like that. But it must be the same as the retrosigmoid approach.

I'm not looking forward to be drilled, but obviously some of you survived... 

There are days when I more or less plan my own funeral, but some days are better. As long as I can work with my pupils at school I don't think so much about everything. It is also a relief to have three teenagers at home who don't take things so seriously. They just say: Mum, you're going to manage this, you're so stubborn, you won't give up until you can get back to work, ride your bicycle and do the things you've always done. I hope they have right! I think I'm most scared of getting a stroke or a blood-clot during surgery or just after. I am also scared to death of getting permanent facial paralysis.

Next week I am going to the hospital to get my balance nerve "killed". I have no idea about how dizzy I'll be, but I think I will suffer a lot from vertigo since both my balance nerves are intact and not at all defected by the AN. I also have full hearing in both my ears. I have been doing exercises for a week now to improve my balance. The doctors here in Sweden think that you'll feel better after surgery if the balance nerve on the good ear already has "taken over", because then you don't have to handle a difficult vertigo at the same time as you're exhausted from the surgery. I don't know if they're right, but it sounds realistic.

Thank again for all your help and support!

Catlover 

[Syl]

I'm not looking forward to be drilled, but obviously some of you survived... 

Catlover 

Catlover,

You will be fine. I do hope they can preserve your hearing. The bigger the tumor, the greater the challenge. Usually, your hearing is harder to save than the facial nerve. But, remember, there are hearing aids for hearing loss. Try to keep a positive attitude--it will help you alot.

Good luck
Syl

[Jim Scott]

Catlover:

Sub-occipital is a term often used interchangeably with retrosigmoid approach for AN removal surgery.  With the sub-occipital/retrosigmoid approach the surgeon cuts through the occipital bone to gain access to the tumor site.

For what it's worth, the mortality rate for acoustic neuroma removal surgery, including all 3 of the most common approaches, is less than 1%.  That is infinitesimal and hardly worth worrying about. 

I had a tumor almost 3 times larger than yours.  I underwent the resigmoid/sub-occipital approach surgery, then radiation.  This 2-step approach was designed to avoid facial nerve damage and offer me the best chance at destroying the tumor.  I was 20 years older than you are and I came through the surgery just fine....no blood clots, strokes or anything else.  I'm not trying to minimize the seriousness of the surgery, just point out that it isn't necessarily a morbid experience.  I had no ill effects from the radiation, either.  Of course, we're all different and I can't guarantee you or anyone the exact same result but with your relatively small AN and what I assume are very competent doctors treating you, I trust you'll do well.  Please don't allow your fears to control you and become an impediment to experiencing a positive surgical outcome.  I think your teenagers are probably right - you'll not only have a successful surgery but be back to your favorite pursuits in no time.   

Jim

[catlover]

Hi Jim,
Thanks for your positive attitude! It helped me a lot to get all the facts that you gave me. I realize I have to stop thinking about my funeral.  I hope it's far away! I also hope that our teenagers are right and that I'll have a manageable outcome that will approve in time.

Thanks again!

What would I have done without this forum and all lovely and helpful people here?

Best wishes,

Catlover

[Denisex2boys]

Hi there - - I saw my 'mortality' cross before my eyes as well - - - - - my surgery was in Oct. (the Thursday after our Canadian Thanksgiving) and also that weekend we closed our summer home for the winter - - I even left a 'note' in my closet - for my family - my kids were 8 and 4 at the time - whilst I knew I would be ok and had a good attitude I was still scared.  So, come may when we open up again for the season I will have to be sure to retrieve that note and get rid of it.  I was a complete basket case the 2 weeks I had notice before surgery - - but that is completley normal.  You will be fine!    I did talk to my kids teachers at school and made them aware of what was going on 'just in case', as well as to lend them some support should they be worried about me while in the hospital.

As for the neck ...... I had the restoid approach and I think a lot of it has to due with incisions as well - - no two of us seems to be carved (pardon the pun) the same - in my case my incision was above the ear straight across to the middle of my head and down my neck - so yes, my neck muscle was severed - and I have GREAT mobility now - the rehab exercises and massage therapy has done wonders - but for a bit I had no neck mobility.

Good luck!

[lacey7]

Hi everyone,
Syl.....just wanted to correct what you said about translab surgery.  They don't go thru the ear canal......I have an incision behind my ear, from the top of my ear down to the middle of my neck.  Just so everyone knows.
Lacey

[Syl]

Lacey,

They drill the skull behind the ear to access the ear canal. I think it was one of my Drs. that explained it to me this way.

Syl