Author Topic: How common is dysphagia following AN removal surgery?  (Read 3169 times)

Amplified2000

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How common is dysphagia following AN removal surgery?
« on: January 02, 2010, 07:58:12 pm »
I'll give the cliff's notes on this one.

In May of 2008 I had a tumor removed from my 10th cranial nerve on the left side, lots of post-op complications including dysphagia (difficulty or inability to swallow) that lasted about 3 months. I really don't want to go through this again so I was curious how many people who have had AN removals experienced any sort of swallowing issues that were not pain/swelling related?

I've decided personally that I'm pretty set on surgery for treatment of my AN instead of zapping but if dysphagia is a distinct possibility I may change my mind.. I can't go through that again.
10th Cranial Nerve Neuroma - 4.6cm x 4.2cm x 6.8cm - Removed 5/08 by Dr. John Leonnetti @ Loyola University
AN - Left IAC - 20mm x 9mm x 11mm - 2/10
Mid-Fossa - Dr. Friedman @ HEI on 3/3/10
Total removal, only mild hearing loss.. did have a CSF leak but they fixed it :)
Home recovering :)

sgerrard

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Re: How common is dysphagia following AN removal surgery?
« Reply #1 on: January 02, 2010, 10:01:21 pm »
Based on a couple of years of forum posts, I would say it is a small possibility. There have been a few reports, sometimes involving the hypoglossal nerve or the vagus nerve, such as in this topic:
http://anausa.org/forum/index.php?topic=7462.0

But it seems to me that it is pretty rare. I don't know how much of a possibility it would take to change your mind, but I think generally it is not a side effect that people worry about ahead of time.

Steve
8 mm left AN June 2007,  CK at Stanford Sept 2007.
Hearing lasted a while, but left side is deaf now.
Right side is weak too. Life is quiet.

Amplified2000

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Re: How common is dysphagia following AN removal surgery?
« Reply #2 on: January 03, 2010, 12:29:20 am »
Well the Vagus nerve is where my last tumor was so it is no longer functioning on the left side.. they really can't damage it anymore during the AN surgery. I like to think that since I've already learned how to swallow again with nerve damage on that side that I should be in as good, or even better position to avoid swallowing issues as anyone else.

It's just the thought of going through that again scares the pants off of me.. really the only side effect in the list that scares me.. SSD? sure I can take it.. Balance issues? sure I can take it.. Facial Issues.. don't want em but I'll take em on if I have too. Swallowing issues put a whooping on me last time and I don't know I could make it through a rematch.

Thanks for the link, it helped me get an idea of the level of issues some people have had to face.
10th Cranial Nerve Neuroma - 4.6cm x 4.2cm x 6.8cm - Removed 5/08 by Dr. John Leonnetti @ Loyola University
AN - Left IAC - 20mm x 9mm x 11mm - 2/10
Mid-Fossa - Dr. Friedman @ HEI on 3/3/10
Total removal, only mild hearing loss.. did have a CSF leak but they fixed it :)
Home recovering :)

leapyrtwins

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Re: How common is dysphagia following AN removal surgery?
« Reply #3 on: January 03, 2010, 12:44:52 pm »
Never had this issue myself post op.

As Steve said, I don't think a large percentage of patients have had this issue.

I'd ask your doc for statistics.

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

jerseygirl

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Re: How common is dysphagia following AN removal surgery?
« Reply #4 on: January 03, 2010, 12:54:36 pm »
Hi Amplified,

Dysphagia is NOT common nowadays in AN removal surgery primarily because the tumors found are small and do not involve lower cranial nerves (X, Xi, XII) and brainstem which can give rise to dysphagia when involved in surgery. Additionally, AN arises from the VIII cranial nerve and even if lower cranial nerves and brainstem are involved,the tumor has to be separated from them which is not considered extremely difficult in either microsurgery or endoscopy. Only truly huge ANs which threaten a person's life can make dysphagia a distinct possibility but, thankfully, not a guarantee.

I had my first AN surgery in 1988 for a huge AN and had dysphagia for a minimum of 2 months afterwards, so I am with you when you state how awful it is. I think all the consequences of it are hard to understand unless a person goes through it. When my tumor regrew, all of it was attached to brainstem and when I heard that it reached Xth cranial nerve, I immediately thought with horror about dysphagia. I was especially concerned that there was pre-existing damage from the first surgery. Well, despite all that, there was no dysphagia after my second surgery!!! Needless to say, I was overjoyed!!! So, rest assured, dysphagia is such a tiny possibility for you that it should not factor into any AN treatment decision.

 I would say it would be prudent though to avoid the area of lower cranial nerves if possible. Retrosigmoid or suboccipital approach has to pass the lower cranial nerves to reach an AN even if it is small while translab or middle fossa do not have to unless they are compressed by the tumor. Middle fossa is not even done on ANs this big anyway. This is just something to think about if you have a choice of the surgical approach.

Good luck and let us know how are you doing.

       Eve
Right side AN (6x3x3 cm) removed in 1988 by Drs. Benjamin & Cohen at NYU (16 hrs); nerves involved III - XII.
Regrowth at the brainstem 2.5 cm removed by Dr.Shahinian in 4 hrs at SBI (hopefully, this time forever); nerves involved IV - X with VIII missing. No facial or swallowing issues.

HeadCase2

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Re: How common is dysphagia following AN removal surgery?
« Reply #5 on: January 04, 2010, 12:42:42 pm »
Hello Amped,
  As others have noted, AN surgery does not normally cause problems with dysphagia.  The few cases I've heard of involved unusually large ANs.  But since you have already had surgery for a tumor on the 10th crasnial nerve, our AN experiances may not apply.  I think you have a valid concern that you should be sure to discuss with your doctor.  It could potentially affect their surgical approach, to help avoid any dysphagia affects.
Regards,
  Rob   
1.5 X 1.0 cm AN- left side
Retrosigmoid 2/9/06
Duke Univ. Hospital

GrogMeister of the PBW

cyrmom2

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Re: How common is dysphagia following AN removal surgery?
« Reply #6 on: January 04, 2010, 12:53:39 pm »
I had dysphagia prior to surgery - especially on days with additional head pressure.  Fortunately I did not have this problem after surgery!

Cyndi
diagnosed 7-27-09 4 cm CPA
12 hr translab 8-25-09
Dr Chicooca & Dr Welling at OSU/The James
sliver of tumor remains on brain stem
left SSD & facial paralysis (was 6/6, 2-3/6 at 9 weeks, 1/6 within 4 months) 6 month MRI on 3-17-10.

Amplified2000

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Re: How common is dysphagia following AN removal surgery?
« Reply #7 on: January 08, 2010, 09:49:53 pm »
Thank you everyone for the input, it helps to hear that it is a pretty rare side effect of mostly larger tumors. I still fully intend to ask my Dr. about this the next time I see him. I am currently scheduled for some "tests" on the 14th (ABR, VNG, ASSR) and will likely have another MRI done shortly as my last one was in April of 2009 and my symptoms have gotten worse since the last MRI so I'm worried about growth. I will update as I find out more of course!
10th Cranial Nerve Neuroma - 4.6cm x 4.2cm x 6.8cm - Removed 5/08 by Dr. John Leonnetti @ Loyola University
AN - Left IAC - 20mm x 9mm x 11mm - 2/10
Mid-Fossa - Dr. Friedman @ HEI on 3/3/10
Total removal, only mild hearing loss.. did have a CSF leak but they fixed it :)
Home recovering :)

mnastasi

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Re: How common is dysphagia following AN removal surgery?
« Reply #8 on: February 08, 2010, 02:20:06 pm »
Hello
I am 3 weeks post op (retrosigmoid).  I did have some issues swallowing..mostly bread, meat.  It seems to be mostly gone now.  I used some compensatory techniques while it was happening..but mostly avoided the foods that caused it.

good luck
merle :)