Melissa,
I'll offer my 2 cents to the other suggestions you have received.
1) The only thing I would agree with the Dr. Lee you consulted with is that surgery for a 1.7 cm AN will in all likelihood result in loss of all usable hearing in that ear. Translab for certain given the nature of the approach which destroys the inner ear, retrosig would be more customary for most docs for an AN that size as Middle Fossa tends to be more appropriate for smaller AN's, but either way the chance of retaining hearing would be 20% or less. My AN was 2 cm and that was the % I was quoted by several neurosurgeons. As Kate, I believe, pointed out, if you opt for surgery translab provides the surgeon with the best view of the facial nerve which most would agree is the higher priority if saving hearing is not likely
2) Dr Lee's assertion that you are not a candidate for radiosurgery would probably not be supported by second opinions from those knowledgeable in that treatment option which I'm willing to bet he is not, or he only does surgery. My AN which was slightly larger than yours was also slightly impacting the cerebellum but not anywhere near a point where any potential radiation induced swelling would be problematic. The commonly accepted "ceiling" for AN radiosurgery treatment is around 3 cm which you are well under. AN's all grow out of the auditory canal and expand into the cerebellpontine angle towards the cerebellum. If you took a 100 3 cm, 2 cm or 1 cm AN's and laid their MRI's over each other I would venture a pretty confident guess that there would not be a significant variation in position on 9 out of 10 of them within each size grouping
3) I think your next step is to get a second opinion from a skilled radiosurgeon, or preferably a neurosurgeon who does radiosurgery such as I had with Dr. Chang at Stanford. Since you went to Cleveland Clinic, you might consider the Univ of Pittsburgh which is renowned for its work with GK. You could also post on the CK doctors board at
http://www.cyberknifesupport.org/forum/ and ask questions to the doctors there. Dr. medbery and Chang will also review scans for free and provide recommendations. Personally, I would not see a value in sending anything to House Ear. While they are certainly on the top end of outcomes and a leader in AN Surgery, they are not experienced practioners of radiosurgery and are not on the leading edge of that treatment option which is what you need a second opinon on. If you want to have surgery, they are certainly a great option, but they offer no insight of value on radiosurgery in my view.
4) AN's are extremely slow growing ( avg 2 mm year) and the facial nerve is much more resistent to damage from the AN than the hearing nerve with it's millions of sound producing tiny hair like fibers. Usually, AN's can get quite large before there are noticeable symptoms in the facial nerve. Permanent facial palsy is generally the result of impact from the surgical removal itself. Conversely, AN's that undergo radiosurgery have facial nerve damage on the order of less than 1%. While I wouldn't expect his recommendation to wait six months to jeopardize the facial nerve to any extent, if you are experiencing symptoms then there is not much point to the wait and watch approach in my view.
Like everyone else here, I'm not a clinician, but those would be my thoughts based on my own journey expereince as well as reading posts on this and other AN boards for 7 years.
Good luck
Mark
