ANA Discussion Forum
Useful Information => Physicians => Topic started by: michele on February 16, 2012, 02:29:14 pm
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UtSouthwestern docs say my 1.3 cm AN sits in an unfavorable (is there a favorable one?) position to preserve hearing. They gave me a 20% chance of hearing preservation and chance of facial paralysis increased to 15% using middle fossa approach. My hearing is normal. My only current symptom is vertigo. Both the Otolaryngologist and Neurosurgeon agreed that if it doubled in size it wouldn't make any difference in its removal. They advised to W & W and maintain normal standard of living as long as I can. My doc also trained at House Ear and was confident that Friedman would say the same. Well...he didn't. Sent him my MRI's and spoke with him yesterday. He said there is a window of up to 1.5cm-1.6cm for middle fossa. I have some wiggle room but not a whole lot. He was extremely confident giving me a 70% chance of hearing preservation and less than 5% facial "weakness" (he quickly corrected my use of the word paralysis). I would like to hear from others given similar stats from Friedman and the outcome. Maybe my interpretation of "weakness" is very different???? I am terrified of facial "weakness". My husband and I have been to a support group meeting and seen what we think are the worst possible scenarios...none of them have me ready to schedule a date. I am a 41 yr old active mom and in good shape.
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Hi Michelle and welcome to this forum .....
I am a Friedman/Schwartz patient but I was not in the same situation that you are. I will tell you this ..... I have 100% confidence in their abilities and trusted them completely before, during, and after my translab surgery last May. Mine was a regrowth situation so hearing preservation was no longer in the mix, but they had to work around scar tissue to remove every last fragment of the regrowth ..... which they did.
I did have a teensy bit of facial weakness ..... ever so slightly asymmetrical smile. It was totally gone in two weeks.
Thoughts and prayers.
Clarice
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Hi Michelle and welcome. I know StephSF just had translab by Friedman and Schwartz Jan 25th and she is fine. No facial weakness and she is SSD cause it was translab. I believe Nancy had Friedman and Schwartz and no facial weakness this was a few years ago. I believe she had retrosigmoid. I am scheduled March 7th retro with Friedman and Schwartz. I too am scared of facial weakness.
Hope this helps
Mindy
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I had Brackmann and Schwarzt--I have no problems. I have 100% confidence in the physicians at House. If I had to do it all over again..its the only team who would get near my head:)
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There is a huge difference between facial weakness and paralysis. Facial weakness is very likely after surgical removal of ANs, but it can be very mild and resolves quickly. My neurosurgeon told me that there was a high likelihood of mild weakness, and only 5% chance of more severe facial paralysis. Like Clarice, I ended up having very mild weakness, noticeable only to the doctors, which resolved within 2 to 3 weeks. The only residual issue that I still have is the dry eye.
Michelle, look into the House-Brackmann scale: it goes from 1-6, with 1 being the mild weakness that I described, and 6 being the most severe paralysis. There is a huge difference between the two.
Another point I wanted to make is that my impression from this board is that House surgeons rarely recommend to W&W. They are confident in what they do, and they do it well, so their recommendation is almost always surgery.
Marianna
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I had Middle Fossa with Brackmann/Schwartz two years ago. My AN was .8mm and was told there was a chance to save my hearing. I did save it, but where I was in the 80% range for word discrimination, now I am at about 50% or less. So in other words, I can cover up my good ear and hear noise out of the bad, but I can't make out one word. (Using iPod headphones I still enjoy "Stereo" though!) I chose to get a BAHA and that has helped greatly! My reasoning to go all the way to LA for MF as opposed to staying here in the Phoenix area where I live and go through Barrow Institute (who recommended translab) was that any hearing preserved would be a good thing. And I would do it all again! I do remember hating this part of the process, trying to decide what procedure to go with and where, but at least you do have options (a good or bad thing?). Take care and let us know what you decide!
Jay
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I finally found my post! Thank you for your replies. :). I know I am much more comfortable at House. Friedman's prognosis makes a lot more sense to me. It only seems logical that tumor growth can only result in more potential damage to surrounding nerves. Has anyone else heard that there is this window of opportunity for middle fossa (1.5-1.6cm)? So I get the impression that when Friedman/Schwartz give a statistic on your chance of hearing preservation and facial weakness that they are fairly accurate? Mindy, may I ask what has made you decide to have the surgery now?
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Michelle I decided to do this now since I am having symptoms of TN. Not as bad as it was Nov-Jan but still there. Since I have to opportunity to go to House because my insurance is in network and so it all just kinda fit together. I don't want to go anywhere else sooooo March 7th it is. ;)
Good Luck with your decisions. If you schedule surgery there let me know when and maybe we will be able to meet.
Mindy