Middle fossa hearing preservation

[red]

Ok-
was reading a site last night that was weighing the pros and cons to the surgeries.  In the middle fossa approach the doctor told us that he recoomended this approach b/c my hubby's hearing was still  very good in that ear.  So these some of these published papers that i read gave some definition of hearing presevation.  I was shock to read that some dr.s considered "hearing preservation" as being able to hear alarm clocks or fire alarms, and that it did not mean that the patient would be able to hear regular conversation or that their hearing would be preserved to a pre- operative state.  What were some of you told about preservation of your hearing.  Did they tell you any level that it would be preserved to, and was it?  I am not sure I would be willing to risk facial nerve damage, balance issues, chronic headaches and everything else just to hear at fire alarm levels.  Any opinions bout this and the levels of preservation. red

[matti]

Hi Red - I had Middle Fossa in order to preserve my perfect hearing. During my pre-op consult my surgeons told me my hearing would not be what it was pre-op, but would still be servicable.  My tumor ended up being larger than anticipated  (3.5cm) and had wrapped itself around the hearing and facial nerves. My surgeons ended up sacrificing the hearing nerve in order to save the facial.  Big surprise when I woke up in ICU, as I had not been told that might happen. 

I have not suffered any headaches since surgery, other than migraines (hormone/weather related) which I have had all my life. I know there was an informal poll taken on here a few months ago, asking about surgical approaches and post-op headaches.

The other post op issues you mention could happen with any of the surgical approaches.

Take care,
Cheryl

[Larry]

Red,

I had middle fossa. I'd already lost about 25% of my hearing pre op (struggled to hear on the phone). After surgery, I can hear noise but no words. Couldn't carry on a conversation.

Hearing loss is likely to get worse as the months roll on (sometimes it doesn't) but be prepared that any hearing loss will almost certainly never be recovered and post surgery, you are likely to lose more.

Share with us the size of the growth because maybe radiation treatment is an option


laz

[Rc Moser]

I would think if any hearing could be saved  the Balance portion could be saved also (I would ask this question). IMO more important that the hearing.  With complete hearing loss and the balance function (semicircular Canal) gone you balance and ability to tell which direction noise is coming from is much more important than levels of hearing in that ear IMO (I know these are the problems I struggle with every day).

If any hearing can be saved and the rest of the Auditrory/vestibular systems intact this would be great IMO.  IMO hearing alittle is alot better than NO hearing or balance function at all.  It will also depend on what the find with they get in there and what it is growing off of. One good thing is must of been caught early and small to be able to preserve any Hearing at all. Hopefully other functions are not damaged yet. Any size AN removal carries a risk of facial nerve damage either from what the nerve has done or when under the knife (odds go way up the bigger the tumor and the longer it's been in there what the toll me). Hopefully the team you have choosen has alot of experience and Patients. especially patients. Not uncommon for AN operations to last a very long time due to trying to get all the tumor and the sac it leaves behind.

My wife was very upset due to I was on the slab for over 18 hours. Time plays on your mind after awhile, but it just took that long to get it all. Also being out for this long IMO affects recovery time IMO. It took me a couple more days to recover and I contribute that to the amount of time I was out and the things it was stuck to. Also had severe headpain and was on Morphin alittle longer which also affected my recover time. I guess what I'm trying to say be prepared and hope for the best.

[vcschaub]

I had middle fossa surgery with only 15% post op hearing loss. I still hear well. The balance nerve was cut and I had very few problems post op because my non AN side had already taken over. My surgeon feels that a malfunctioning balance nerve causes more problems than no balance nerve.

[Patti UT]

HI Red,

    In my opinion,  SERVICABLE hearing is far different than MEASURABLE hearing.  I had middle fossa. I was told that the size of the tumor and the measured hearing that I had were on the border line of using the middle fossa, but that they wanted to go that rout to try and preserve the hearing I did have in that ear.  After the fact, I find that sure, they can measure some hearing, but it is in no way SERVICABLE. If I sleep on my good ear, I can't hear anything, alarm cloek, anything. I can bearly make out a faint sound if I put the phone to that ear. I can't hear when people talk to me on that side. ANd like Larry said, it does seem to get worse as the months go by post op.  SOmetimes, I feel like it's harder having the tiny bit of distorted hearing than to not have any at all in that ear. because I am always straining to try and hear with the little bit of hearing that is supposively there.
I don't believe going another approach will insure the saving of the balance nerve though. It will all depend on if the tumor is wrapped around it or not. Typically these tumors originate on the balance nerve. I lost the whole balance nerve. I do believe the Trans Lab is less invasive of the facial nerve through. I was fortunate that my facial paralysis was temporary, lasted 3-4 months, now at 2 years out, The effects of the paralysis is so suttle you can't tell. Still have the dry eye, and some other stuff from it byt looking at me I look fine.  Oboviously I'm no Doc, so keep writing all these questions to ask him.  Also remember, the Doc has never HAD the surgery. So the input from the folks on this forum, really is of great importance, even though were not Docs.

Patti UT

[Gennysmom]

Hi Red,

I had an audiogram before my surgery that rated my hearing of the spoken word at 16%.  I already couldn't hear alarms, etc, if I had my good ear to the pillow before surgery.  I then  had translab, so I have SSD, and I do notice the difference, even though my hearing level before was almost nil.  I'm constantly having to ask "what was that?" as sounds sound different to me now.  I do miss it, but I'm also thankful that I didn't have to go from perfect hearing to low or no hearing.  For me, facial nerve preservation was the #1 concern (besides basic life support stuff).  You never know if balance will be a concern pre-surgery....I had a large tumor and I figured that I would have compensated already...but no, I had yucky balance issues.  The only headaches I've had were related to a CSF leak.  But translab is a BIG decision if you have good hearing....my choice might have been different, risk of headache and all, if I had hearing to save.  But facial nerve still would have been my #1 concern.  I would tell you to go with your gut and don't second guess yourself.  What does your gut say?   

[vcschaub]

I just went back and looked at my records. When I was first diagnosed, my hearing was at 100%. My primary symptom was lack of balance and ear fullness. One year later, my hearing had reduced to 85% and my tumor had grown. I had middle fossa surgery and now, 11 months later, my hearing has held at 76%. The percent is actually for the speech discrimination. So my hearing was only reduced 9% since surgery. So far, so good. My facial nerve was intact although I developed delayed facial weakness which is now resolved.

[red]

Thankis for clearing up some of the concerns obout the hearing preservation. I agraee that facial nerve preservation is numero uno on our list. just wish we knew the unknowns like how sticky the timor is and what ist stuck to!   Oh well,  We are leaning towards the MF but still have two consults  before making any decision.  Had Dr. Hitselberger call back today, 30 minutes after i left a message with the secretary.  Quite impressive!  Hopefully we will have a phone consult within the end of the week.  thanks guys for all the response and help,  we really appreciate all of you and you input.  Red 

[Desilu]

Hi Red,

Dr. Hitselberger is totally awesome! He is such a nice guy and a great neurosurgeon. I would do it all over again if I had to with him and Dr. Brackmann. You will be in good hands if you choose them. Ann