Author Topic: does size of wound vary?  (Read 8647 times)

Alison

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does size of wound vary?
« on: September 11, 2012, 04:51:00 am »
Hi all,

I'm newly diagnosed and waiting for my first apt to discuss options with the surgeon.  Although it's not a major consideration compared with all the other post treatment after affects, (I'm learning something new everyday on this amazing site) I was wondering if the wound size varies between the translab and retrosigmoid operations and if a metal plate is involved in the latter? Am I right in thinking the retro does not involve the abdominal fat infill?

Many thanks for any information on this,

Alison



 
CPA and IAC AN 14.5mm x 10mm x 8mm diagnosed August 2012 treatment in UK SRS Linac with headframe  Dec 2012 MRI 4 month post April 2013 was 18mm x 13 x 7.8 (this April MRI was not measured until Jan 2014) MRI January 2014 was 17mm x 11.4 x 8.3 (one year post)

CHD63

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Re: does size of wound vary?
« Reply #1 on: September 11, 2012, 07:25:41 am »
Hi Alison .....

See my reply to your other post.

Clarice
Right MVD for trigeminal neuralgia, 1994, Pittsburgh, PA
Left retrosigmoid 2.6 cm AN removal, February, 2008, Duke U
Tumor regrew to 1.3 cm in February, 2011
Translab AN removal, May, 2011 at HEI, Friedman & Schwartz
Oticon Ponto Pro abutment implant at same time; processor added August, 2011

New girl

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Re: does size of wound vary?
« Reply #2 on: September 11, 2012, 03:50:21 pm »
Hi Allison,

Sorry you are going through this.  I had retro and I have titanium mesh and the fat infill.  My abdominal incision healed quickly.  It wasnt painful.  I'm not sure about the size of the wound when comparing the two surgeries.  If you want I can try sending you a picture of mine.  We took a picture of it in the hospital.

Best wishes.
9mmx14mmx9mm
Diagnosed 6/1/2011
Retrosigmoid Surgery 9/27/2011
Daniel Lee (MEEI) & Fred Barker (MGH) - Exceptional Surgeons

mindyandy

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Re: does size of wound vary?
« Reply #3 on: September 11, 2012, 04:33:03 pm »
I had Retro and I did have abdominal fat fill in. Ugly scar on the tummy.

Mindy
14mm dx 9/07. CK done Seattle  1 year MRI showed some shrinkage. 4 year MRI 2mm growth nothing conclusive. Trigminal nerve involvment Retrosigmoid Friedmand/Schwartz HEI March 7,2012

LakeErie

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Re: does size of wound vary?
« Reply #4 on: September 11, 2012, 06:19:02 pm »
I, too, had retrosigmoid approach. The cranioplasty used a titanium plate. Titanium is a non-magnetic metal, or non-ferrous, so there is no problem with MRI's after surgery. ( MRI = Magnetic Resonance Imaging )
You asked on a different thread about different incision and opening sizes in the skull. I had a minimally invasive procedure: incision was 5 cm ( 1.98 inches ) and the craniectomy was 2 cm in diameter, roughly same diameter as a quarter.
« Last Edit: September 11, 2012, 06:21:15 pm by LakeErie »
4.7 cm x 3.6 cm x 3.2 cm vestibular schwannoma
Simplified retrosigmoid @ Cleveland Clinic 10/06/2011
Rt SSD, numbness, vocal cord and swallowing problems
Vocal cord and swallowing normalized at 16 months. Numbness persists.
Regrowth 09/19/2016
GK 10/12/2016 Cleveland Clinic
facial weakness Jan 2017

leapyrtwins

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Re: does size of wound vary?
« Reply #5 on: September 11, 2012, 09:19:39 pm »
Retrosigmoid for me, too.

I have titanium mesh and a titanium plate, as well as belly fat (abdomenal scar is non-existent for me).

The scar from my retrosigmoid incision looks like this >

It's behind, and a little bit above, my left (AN) ear.

My BAHA implant site is directly on top of my AN surgery site.

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

Alison

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Re: does size of wound vary?
« Reply #6 on: September 12, 2012, 01:49:21 am »
Thanks so much for your replies.

It's so helpful to have knowledge passed on from those who've experienced it. I feel I'll be able to ask the right questions when I eventually get my apt.

Does anyone know why some surgeons use abdominal fat and others don't? Am I right in thinking titanium is always used in the retro procedure, but in translab they just staple the wound? So many things to be prepared for.

Newgirl, thanks for the offer of a photo. Clarice has kindly offered too, and said I have to reply to the email she sent me so she can get my address and attach the pic. I'm in the UK so we have a time lag of between 5 to 8 hours, eg it's 8.45am in the Uk as I'm typing this.
Thanks again,

Alison
CPA and IAC AN 14.5mm x 10mm x 8mm diagnosed August 2012 treatment in UK SRS Linac with headframe  Dec 2012 MRI 4 month post April 2013 was 18mm x 13 x 7.8 (this April MRI was not measured until Jan 2014) MRI January 2014 was 17mm x 11.4 x 8.3 (one year post)

mk

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Re: does size of wound vary?
« Reply #7 on: September 12, 2012, 07:14:27 pm »
Most of the times retrosigmoid involves a titanium mesh, but not always. I had retrosigmoid, but my surgeon does not use titanium mesh, nor a fat graft. He replaces the bone that was removed during craniotomy and uses some sort of bone cement (polymethylmethacrylate) to glue it back in place.

Marianna
GK on April 23rd 2008 for 2.9 cm AN at Toronto Western Hospital. Subsequent MRIs showed darkening initially, then growth. Retrosigmoid surgery on April 26th, 2011 with Drs. Akagami and Westerberg at Vancouver General Hospital. Graduallly lost hearing after GK and now SSD but no other issues.

leapyrtwins

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Re: does size of wound vary?
« Reply #8 on: September 13, 2012, 05:44:47 pm »
Does anyone know why some surgeons use abdominal fat and others don't? Am I right in thinking titanium is always used in the retro procedure, but in translab they just staple the wound?

Docs do different things.  There is a theory that abdominal fat is supposed to help prevent CSF leaks, but I don't think it's a theory that has been proven.  I had the fat graft and didn't have a CSF leak, but it might just be a coincidence.

Don't know if they use titanium with translab or not, may be another doc preference, but my incision wasn't stapled.  It was stitched and my doc removed the stitches 9 days post op.  I'll never forget that it was 9 days because I couldn't shampoo my hair for 9 days  :P

Here are pics of my incision.





First picture is about 2 days post op after my bandage was removed.  I still have purple ink on my ear lobe (docs mark which side your AN is on).

Second picture is about 1 week post op (surgery was 5/31/07).  The "goop" in my hair and on my stitches is bacitracin.

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

CHD63

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Re: does size of wound vary?
« Reply #9 on: September 13, 2012, 06:25:30 pm »
Keep in mind that individual results ..... and incisions ..... vary, depending upon the surgeon.  I have had two retrosigmoid approach surgeries, with two different surgeons in different states and neither one of mine were nearly as long nor as deep a curve as Jan's.  My translab surgery was also not nearly as long and of course more above and nearer the ear.  Just did not want to scare someone and also to reinforce that different surgeons have different surgical styles.

Clarice
Right MVD for trigeminal neuralgia, 1994, Pittsburgh, PA
Left retrosigmoid 2.6 cm AN removal, February, 2008, Duke U
Tumor regrew to 1.3 cm in February, 2011
Translab AN removal, May, 2011 at HEI, Friedman & Schwartz
Oticon Ponto Pro abutment implant at same time; processor added August, 2011

Alison

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Re: does size of wound vary?
« Reply #10 on: September 14, 2012, 02:02:14 am »
Thanks Jan for photos, they are really helpful. Also thanks Clarice for the added comments. How did you find sleeping, as no doubt it was impossible not to lie on the wound as you turned in your sleep?

Jan, I notice from your tumour stats that yours grew considerably in 6 weeks. Did you notice worsening symptoms over this period? I have a long wait to get my first apt here in the UK although I'm trying to hurry them up.

In addition to the balance dizziness and tinitus symptoms I'm getting increasing left eye related issues, twitches/stinging. Just worried it may be sign it is growing, especially as my symptoms all kicked off after reluctantly taking a 2 week course of progesterone 3 months ago. I've heard hormones may possibly be connected to tumour growth spurts. Of course it may have been dormant for years.

Many thanks,

Alison 
CPA and IAC AN 14.5mm x 10mm x 8mm diagnosed August 2012 treatment in UK SRS Linac with headframe  Dec 2012 MRI 4 month post April 2013 was 18mm x 13 x 7.8 (this April MRI was not measured until Jan 2014) MRI January 2014 was 17mm x 11.4 x 8.3 (one year post)

sarahinPA

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Re: does size of wound vary?
« Reply #11 on: September 15, 2012, 10:33:55 am »
hi Allison, im just catching up with your posts.

My incision is like a C shape, starting at the top of my ear curving towards the bottom of my ear. I had 22 staples to close it up. I have titanium mesh, and no belly fat. From what i understand that is a surgeons preference. A friend of mine had brain surgery (for a totally different issue) and her surgeon replaced her skull piece.

My words of advice, depending on how long your surgery will be, your body may be sore, in fact this was worse pain for me than the actual surgery. I was in surgery for 15 hours, and my body was in the sme position, during that period i also developed a blood clot from not moving after surgery, so make sure that you get up and out of bed as soon as you can. I did not have pain on my incision like I thought that I would. Of course i favored my other side when sleeping the first few days, but my neck hurt so bad that i couldnt really turn it to sleep anyways,. and i slept in a sitting up position for the first few days. Once i could move my neck more, i actually slept on my incision side, because i had an IV on my non AN side in the arm, and i couldnt lay that way or else i would cut off the IV drip. This was all bevause i had a prolonged stay in the hospital due the blood clot, but i am more in the minority than the majority.

once in awhile now, my incision bugs me, when i lay on it, but i just turn over and everything is fine. But for the most part, i dont realize its there, except for the dreaded ringing in my ear that gets louder and louder......

good luck, and use this website for so much and learn so much. The people here are amazing and great supports. Im not on as much as i used to be leading up to surgery, but each person on here still holds a special part in my heart for the support they gave me.
2.3cm Diagnosed 12/19/08
Gamma Knife @ UPMC Pittsburgh 1/12/09
.2mm Regrowth 6/2011
Translab 7/29/11 @ UPMC
     temporary paralysis of throat-feeding tube 8 days; SSD; facial numbness; blood clot & pnemonia developed; 11 days hospital stay.

leapyrtwins

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Re: does size of wound vary?
« Reply #12 on: September 20, 2012, 10:56:51 pm »
Jan, I notice from your tumour stats that yours grew considerably in 6 weeks. Did you notice worsening symptoms over this period?

My symptoms didn't change between the time I was diagnosed and the time of my surgery (approx. 6 weeks) so I had no idea my AN was growing.

Symptoms were fullness in my left (AN) ear and diminished hearing.  I also had balance issues that I was unaware of until my doc tested me during my initial consultation with him.

Glad the pictures were helpful; actually I've seen much worse (longer and deeper) AN scars than mine.  Lots of pictures on the Forum if you search.

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