Author Topic: Talked to House Institute in LA  (Read 5043 times)

CoachDJ

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Talked to House Institute in LA
« on: December 09, 2009, 08:47:04 pm »
Talked to Doctor Wilkinson @ House he said my tumor was 2.1x 2.6x 2.0cm.  He felt like my best option was trans lab surgery.  He looked at my MRI and said the tumor was presssing against my brain stem.  He also said tumor was all the way out to my Cochlear.  Could I get some input from you guys about trans lab and any of you that have had some of these same symptoms. 

Thanks,

DJ

loose screws (tightened)

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Re: Talked to House Institute in LA
« Reply #1 on: December 09, 2009, 09:48:16 pm »
DJ.

I met Dr. Wilkinson while I was recovering in the hospital after my middle fossa surgery. Dr. Brackmann was my surgeon but for some reason Dr. Wilkinson came in to check on me. He seemed very knowledgeable and was concerned about swelling I had. If your questioning his choice of approach ask him why he chooses trans lab over middle fossa or retrosigmoid. This is a one time deal so don't be afraid to ask him anything.

From what I learned during my research before my surgery, hearing preservation is not possible with the trans lab but is with the retrosigmoid approach and the middle fossa is supposed to give the best chance for hearing preservation. Trans lab does not put the facial nerve at risk the way that the middle fossa does. I think the location of your tumor is probably the main reason Dr. Wilkinson would choose one over another.

It seems to me that I remember reading that the retro approach was the best approach for tumors when the tumor is located mostly outside the internal auditory canal and adjacent the brain stem.

I would ask him why not the retro approach. That would seem like the best approach for the location of your tumor the way you explain it.
Hopefully someone more knowledgeable than I can chime in here.

Best of luck.
Mike
47 Y/O. diagnosed AN After MRI. 4X5X7mm within the right auditory canal. Slight hearing loss, ringing in ear, vertigo. Middle fossa with House Ear Clinics Dr Brackmann and Dr. Schwartz on 11-16-09. 6 new tightened titanium screws but no more hearing.
http://mikessurgery.blogspot.com/

CoachDJ

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Re: Talked to House Institute in LA
« Reply #2 on: December 09, 2009, 09:51:29 pm »
I have very little hearing left Mike, that, and the size of my tumor is why he suggested the trans lab I think

Pooter

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Re: Talked to House Institute in LA
« Reply #3 on: December 10, 2009, 03:52:28 pm »
DJ,

Not be dense or anything, but I wouldn't suppose that size of the tumor would indicate an approach over another.  I would think that location of the tumor has more to do with the approach than size.  My doctor was convinced they were going to do Translab and then after consulting with his partner (neurosurgeon) they agreed that retrosig was a better way to go.

I doubt it had to do with size (mine was 3cm+), but more to do with location and proximity to vital brain structures (e.g. facial nerve).

Many times, especially with those people who've lost a lot of hearing pre-surgery then hearing preservation is not even considered a factor.  As Jenni told my doctor when we met pre-op, she was more concerned with having to buy 2 rocking chairs when she was old than with whether or not I could hear perfectly or not.

Just my $0.02 worth..

Regards,
Brian
Diagnosed 4/10/08 - 3cm Right AN
12hr retrosig 5/8/08 w/Drs Vrabec and Trask in Houston, Tx
Some facial paralysis post-op but most movement is back, some tinitus.  SSD on right.
Story documented here:  http://briansbrainbooger.blogspot.com/

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leapyrtwins

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Re: Talked to House Institute in LA
« Reply #4 on: December 10, 2009, 08:26:59 pm »
I'm not a doctor, but I'm with Pooter.

I think that approach has more to do with location - than size.   Translab is also supposed to give the patient less of a chance of facial paralysis than retrosigmoid - although there are plenty of us who had retrosig and don't have facial paralysis.

Very little hearing is also sometimes a deciding factor in docs doing the translab approach - the issue of automatically taking your hearing doesn't exist since it's already gone.

I had the choice of translab or retrosigmoid (and radiation for that matter) but didn't want to choose translab because I still had fairly good hearing and very good word recognition.  In my case if my hearing would have been worse, I would have chosen translab.

Just my 2 cents worth.

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

CoachDJ

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Re: Talked to House Institute in LA
« Reply #5 on: December 11, 2009, 08:11:43 am »
thanks guys, I appreciate the input, my hearing is virtually gone in my right ear, perhaps another reason for the trans lab

cindyj

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Re: Talked to House Institute in LA
« Reply #6 on: December 11, 2009, 10:03:33 am »
Hey, Coach!  My tumor was on the smallish side, but the location (as Jan and Pooter mention) was the main factor in my choosing translab...even though my hearing pre-op was as near perfect as you can get without actually being perfect.  Mine was right on the brain stem aslo.  Dr. Friedman said the chance of saving my hearing was negligible.  Also, I just had a suspicion/gut feeling that mine was also right on the facial nerve and I wanted the approach with the best view of that nerve, so translab was my choice as well.  Turned out to be the right choice in my case.  To me, the hearing loss has been a small price to pay.  The tinnitus is the worst part of the hearing loss issue, and that was there long before surgery and would continue to be there no matter the treatment I chose.

Wishing you the best,

Cindy

rt side 1.5 cm - Translab on 11/07/08 Dr. Friedman & Dr. Schwartz of House Ear Institute,
feeling great!

"Life consists not in holding good cards, but in playing well those you do hold."  Josh Billings

leapyrtwins

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Re: Talked to House Institute in LA
« Reply #7 on: December 11, 2009, 06:09:29 pm »
thanks guys, I appreciate the input, my hearing is virtually gone in my right ear, perhaps another reason for the trans lab

DJ -

you are correct; this is a very good reason for TransLab.

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

msmaggie

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Re: Talked to House Institute in LA
« Reply #8 on: December 11, 2009, 06:58:51 pm »
When I sent my MRI to House for a consultation, Dr. Wilkinson was the dr. who called me.  He was extremely helpful and was actually the first one to decide that my tumor was a meningioma instead on an AN.  I had my surgery in Houston instead in CA, but my dr. here was not convinced that it wasn't an AN until the surgery was over.  Dr. Wilkinson was right all along.  I really appreciated all the info he gave me.

Priscilla
Diagnosed  left AN 8/07/08, 1.9 CM
Surgery 12/10/08 at Methodist Hospital w/Vrabec and Trask for what turned out to be a cpa meningioma.

Mei Mei

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Re: Talked to House Institute in LA
« Reply #9 on: December 19, 2009, 06:35:51 am »
I also talked with House Institute after sending my MRI and audiogram of a 35dB right ear loss and 1 cm AN.  Dr. Friedman was very helpful and suggested a Middle Fossa approach because the tumor is completely in the canal and shows good chance for preservation of hearing.  He didn't mention facial nerve at all.   I am seeing Dr. Tamargo at Hopkins on Monday to see what he says...I don't want to lose my hearing but I also don't want a a facial paralysis. 
Mei Mei
1 cm Tumor RetrosigmoidSurgery on Jan 12 at Johns Hopkins
Drs. Niparko and Tamargo
35dB loss pre surgery and now SSD
Post surgical Headaches and Tinnitus
Dr Ducic Georgetown Excision Surgery May 2011
Dr. Schwartz GW  Titanium Mesh  March 2012
Drs Kalhorn/Baker, Georgetown Removal of Titanium Mesh

Sonja

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Re: Talked to House Institute in LA
« Reply #10 on: January 02, 2010, 03:36:54 pm »
HEI was one of the 8 consultations I had. I spoke with Dr. House, who suggested Translab. I had no servicable hearing in my AN ear. As such I was more concerned with my facial nerve, which you see first during Translab.

I did decide on HEI for my surgery and was in agreement with Dr.  House and had Translab surgery in February 2009. During TRanslab I also decided to also have the BAHA inplant.  I have not been wearing my BAHA, but plan to in 2010.  I have adjusted very well to SSD.

I am back to my life as it was before surgery for the most part. My AN eye does not tear (did not pre-op) and am SSD. Other than that I am pretty much back to me pre-op and pre AN.

If you have no sevicable hearing Translab seems like a good approach. I wish you the best. Go with your gut.

Sonja
Symptoms 2005
AN diagnosed January 2007
Watch & Wait until now
Surgery (Translab) scheduled February 18, 2009 HEI (Dr. House, Dr. Schwartz, Dr. Stefan)
No servicable hearing in affected ear

 


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