ANA Discussion Forum
Treatment Options => Microsurgical Options => Topic started by: v357139 on April 30, 2013, 03:40:46 pm
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Does retrosig still have higher rate of debilitating longer term bad headaches than translab? What has been people's experience? I know they have made advances with retrosig craniotomy, and trapping the bone dust with gel foam. Who has had very bad headaches with retrosig? Has anyone had this problem with translab?
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Does retrosig still have higher rate of debilitating longer term bad headaches than translab? What has been people's experience? I know they have made advances with retrosig craniotomy, and trapping the bone dust with gel foam. Who has had very bad headaches with retrosig? Has anyone had this problem with translab?
I underwent a partial resection of a large (4.5 cm) AN in 2006 and did not experience headaches, before or after the (9 hour) surgery. My neurosurgeon was very experienced in AN surgery (30 years) and when I asked (pre-op) about the possibility of post-surgical headaches, he told me "my AN surgery patients don't have post-op headaches." He was correct. Of course this is one patient, one doctor, although others here have had a similar experience with Retosigmoid Approach AN surgery.
Jim
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Yes I remember you saying that. Has anyone had bad headaches after retrosig? What about translab?
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Hi;
Through the years, I've read a many with post op RS HAs. They did change a surgical closing part a few years and as I understand things, there are fewer who get post op RS HAs.
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I had retrosigmoid surgery and have almost no headaches post surgery. I have minor ones now sporadically which go away with ibuprofen. I had some really bad ones pre surgery which I thought was due to allergies but now I think the tumor was a contributing factor. I know one of forumites named Mei Mei has a lot of post surgical issues. You may want to look through some of her posts.
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I had translab and have not had post op headaches,,haven't really noticed any posts that have said they have after this procedure , have known a few folks that have reported headaches and neck muscle pains from retrosig though; however , as some have stated procedure may have changed some to avoid incident ,, good luck
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I am wondering because all the docs say they cannot save my hearing. And one doc said he would go either retro or translab, and kind of left it up to me. If my hearing cannot be saved, is there a reason to go retro?
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Hi;
Re, RS; Do you have any tone response at all? 0% speech discrimination is not necessarily complete deafness and a tone response may allow for a sense of determining sound direction.
TL does allow for a better view of the facial nerve, I believe.
I'm not positive, but believe RS allows the neuro to salvage the vestibular nerve branch in some cases.
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I really can't speak to reason for retro if saving hearing is not the reason given to do that procedure ,, my hearing was good , at least I thought so!!,,, but was told translab would give them best view of facial nerve , and if that is what was most important to me,, then translab was what I needed,, mine was pressing on brainstem so had to do something ,, BUT it also depends ALOT on surgeons experience and location of tumor ,, there are so many variables that come into play with these tumors,, and SO much "they" don't know till they get "in there" ,,, That "results may vary SO much with each of us" ,,,, so that is my "two cents worth",,,,, take it for what it's worth,,,,,,no guarantees can/ should be given with any procedure ,, IMO,, best of luck Jane
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Hi;
Re, RS; Do you have any tone response at all? 0% speech discrimination is not necessarily complete deafness and a tone response may allow for a sense of determining sound direction.
TL does allow for a better view of the facial nerve, I believe.
I'm not positive, but believe RS allows the neuro to salvage the vestibular nerve branch in some cases.
Yes I still have 65% hearing in that ear. But due to size 2.7cm, even the docs that propose retro are saying the chances are very slim or none, to save hearing. One doc did a BAER test as a predictor, and he said cannot save hearing, even though he prefers the retro. Another doc said as much chance as winning the lottery.
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I really can't speak to reason for retro if saving hearing is not the reason given to do that procedure ,, my hearing was good , at least I thought so!!,,, but was told translab would give them best view of facial nerve , and if that is what was most important to me,, then translab was what I needed,, mine was pressing on brainstem so had to do something ,, BUT it also depends ALOT on surgeons experience and location of tumor ,, there are so many variables that come into play with these tumors,, and SO much "they" don't know till they get "in there" ,,, That "results may vary SO much with each of us" ,,,, so that is my "two cents worth",,,,, take it for what it's worth,,,,,,no guarantees can/ should be given with any procedure ,, IMO,, best of luck Jane
One doc gave me the choice. I said try to save hearing, even though he only gave me as much chance as winning the lottery. So I am wondering if retro is worth it, for such a small chance of saving hearing, if there is more of a chance of bad headaches with retro. Craniotomies and bone dust trapping have been around a long time now.
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I had retrosig surgery because I wanted to save my 65% hearing, but I lost more of my hearing with the surgery.
I hardly ever got headaches before the surgery & became a chronic headache sufferer post-surgery. However, I don't know that translab would have resulted any different in the headache department. Do I regret my decision? Not at all.
In June, it will be 5 years since my surgery. I still get more headaches than I used to in my pre-AN life, but they are not chronic & they are much more manageable.
Syl
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As Jane pointed out, surgeons experience and location of the tumor are very important. In some cases where the tumor is located on the CPA, a surgeon may feel like retro gives better access. When there is a significant component inside the IAC, translab may be more appropriate.
I have seen headache sufferers with both translab and retro, and also many people who had retro and do not suffer of headaches. With regards to facial nerve, some (most) surgeons believe that translab offers the best view of the facial nerve, but some (like my surgeon) believe that the facial nerve gets exposed too early during translab, therefore having more chances for injury.
All this mainly depends on the preference/expertise of the surgeon. In my experience I wouldn't fret too much on the choice of approach, rather more the surgeons preference. My surgeon, who mostly operates on large tumors, specializes in retrosigmoid, and has refined his technique using this approach. His patients don't get headaches, or facial problems. So I trusted him with retro, even though I didn't have any hearing left to salvage. Other surgeons may equally be very skilled on translab, and recommend it accordingly.
If you really feel strongly that you would like to have one approach, or another, seek a doctor who has a preference and expertise on this approach.
Marianna
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Does retrosig still have higher rate of debilitating longer term bad headaches than translab? What has been people's experience? I know they have made advances with retrosig craniotomy, and trapping the bone dust with gel foam. Who has had very bad headaches with retrosig? Has anyone had this problem with translab?
I underwent a partial resection of a large (4.5 cm) AN in 2006 and did not experience headaches, before or after the (9 hour) surgery. My neurosurgeon was very experienced in AN surgery (30 years) and when I asked (pre-op) about the possibility of post-surgical headaches, he told me "my AN surgery patients don't have post-op headaches." He was correct. Of course this is one patient, one doctor, although others here have had a similar experience with Retosigmoid Approach AN surgery.
Hi Jim I wonder if it also helped that you only had a debulk. In that case, there was probably no drilling into the IAC, so no resulting bone dust. Just a thought.
Jim
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Hi;
Through the years, I've read a many with post op RS HAs. They did change a surgical closing part a few years and as I understand things, there are fewer who get post op RS HAs.
Even with those RS improvements, do some people with RS still get those nasty headaches, more than translab? That is what i am trying to figure out.
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I had translab and have not had post op headaches,,haven't really noticed any posts that have said they have after this procedure , have known a few folks that have reported headaches and neck muscle pains from retrosig though; however , as some have stated procedure may have changed some to avoid incident ,, good luck
Yes I am trying to understand if even with the retrosig improvements, retrosig might still have more headaches than translab?
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I had retrosig surgery because I wanted to save my 65% hearing, but I lost more of my hearing with the surgery.
I hardly ever got headaches before the surgery & became a chronic headache sufferer post-surgery. However, I don't know that translab would have resulted any different in the headache department. Do I regret my decision? Not at all.
In June, it will be 5 years since my surgery. I still get more headaches than I used to in my pre-AN life, but they are not chronic & they are much more manageable.
Syl
Yes I just wonder if translab causes less headaches than retro. So hard to know.
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Hi Jim I wonder if it also helped that you only had a debulk. In that case, there was probably no drilling into the IAC, so no resulting bone dust. Just a thought.
The tumor was approximately 4.5 cm and was reduced to approximately 2.5 cm. I think it would be safe to assume that bone dust was present from drilling through and removing a piece of my skull to gain access to the tumor. However, I'm not a physician and can only offer my experience as a patient who underwent Retrosigmoid Approach AN debulking surgery and enjoyed a successful outcome. How you interpret that result is your call. Because there is no guarantee of outcome, AN surgery decisions are inherently difficult. I can only hope that you can use the feedback offered here to aid your decision in a way that works out well for you.
Jim