Micro + GK to preserve hearing...is it worth it?

[kmr1969]

My AN is 2.7 cm and touching the brain stem which makes GK only a bit of a concern for me and the last doctor (radiation oncologist) that I saw.  He suggested that I may want to consider a partial resection to get about 60% of the tumor and then follow up with GK to blast the rest.  This same recommendation was also made by the last neurosurgeon I saw.  I believe the surgery approach would be retrosigmoid.

My original neurosurgeon recommended the translab approach due to the size of my tumor and his opinion that it would be very unlikely that my hearing could be preserved via a different surgery approach.  This opinion was confirmed by a second neurosurgeon.

My last hearing test showed about 95% hearing for speech and I still use that ear on the telephone with little trouble.

I am not that excited about going through both procedures and opening myself up to risks associated with both treatments.

Has anyone gone through both treatments to try and preserve their hearing?  Did it work?

Trying to figure out the advantages and disadvantages, and whether it is worth it.

Thanks,

Ken

[rupert]

What you're describing is fairly common these days and many doctors are using this approach as standard procedure.  Mainly to preserve the facial nerve, but I suppose hearing also.  Hearing preservation is a gamble with either approach.  AN's are notorious for zapped hearing before and after treatment. Alas that is the sad facts. 

[leapyrtwins]

What you are describing is called debulking and Rupert is right, it's typically used for preserving the facial nerve when the AN is large.

That said, 2.7 cms isn't really large; large is more like 4 to 4+ cms. 

Whether or not debulking would save your hearing is hard to say; it's a crap shoot. 

Translab would automatically take your hearing, retrosigmoid would give you a chance of saving it, but the odds aren't good.

My AN was 3 cms, I chose retrosigmoid and ended up SSD; but I knew going into surgery that I had a very good chance of that happening.  I decided to take the gamble because I wanted my docs to at least try to save my hearing.  I wasn't comfortable just "letting go" of my hearing, because although it was diminished I had good word recognition.  I figured if they could save it, great.  If not, at least we could say we tried our best.

I don't regret my decision, but you need to do what you think is best for you.

Jan

[Jim Scott]

Hi, Ken ~

I underwent Retrosigmoid approach AN debulking surgery for a 4.5 cm AN in 2006.  The neurosurgeon 'peeled' the tumor down to approximately 2.5 cm and this 'thinned' it out, making it very susceptible to radiation.  After a 90-day 'rest period' (my doctors term) I underwent radiation in the form of FSR - 26 sessions. 

Unfortunately, my hearing had already been lost in the affected ear so I cannot offer a personal opinion on hearing preservation using debulking & radiation.  However, I can state that the debulking (9-hour surgery) went splendidly.  I experienced no facial paralysis or other issues, was home within 5 days of the surgery and driving again barely 2 weeks after the surgery (with my doctors permission).  The FSR presented no problems at all.  Better yet, later MRI scans indicated tumor necrosis and the beginning of tumor shrinkage.  Today, I'm doing great and just wanted to let you know that, although I can't comment on hearing preservation with tumor debulking and radiation, in every other aspect they were very successful in my case.

Jim

[susierg]

I had a tiny 7mm AN and had Mid Fossa surgery this past July.  Was told that Mid Fossa was the best choice for hearing preservation.  My hearing was 100% in both ears before surgery.  Unfortunately, I lost the hearing in my AN ear.  There's just no guarantee no matter what size.   

[millie]

I am having translab Oct 17th and my hearing has deteriorated greatly in my AN ear the last six months.  I understand your worry about total hearing loss in that ear and I play games with my right ear to see if I can hear anything at all now in the left ear.  However  I   am thinking the pros will outweigh the cons of trans-lab-I am also trying to adjust to what I am thinking will be the new normal and a new beginning. Have faith .  Best wishes.  Millie