Author Topic: retrosigmoid approach at House  (Read 7837 times)

meh

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retrosigmoid approach at House
« on: October 30, 2006, 03:14:13 pm »
Has anyone had surgery with retrosignmoid approach at House Ear Institiue? How was the result?

Does it cause severe headaches?

How is the result with facial and balance nerve?

is there a chance to loose hearing with ritrosigmoid approach as we have heard that with retrosigmoid we can save the hearing.


My husband has diagnoised with 1.8 cm of tumer in the left ear. at Michigan Ear Institute we had suggested Translab approach.

At HEI we had suggested Translab and retrosigmoid both, in which retorsigmoid has chance to save the hearing but can cause headaches. He has lost around 30 to 35% of hearing yet.

Does anyone know the statistics at HEI for retrosigmoid approach?


Battyp

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Re: retrosigmoid approach at House
« Reply #1 on: November 01, 2006, 07:58:25 am »
I don't know hei's stats for retro  but will tell you that yes you can lose hearing with retro but...you can retain it too.  I had little to none going in and I can faintly hear a dial tone in a quiet room.  My facial nerve is intact no paralysis but suffered from facial numbness.  I was told by an ENT who did not perform my surgery that the numbness was more than likely from the damage to the trigeminal nerve due to delay in diagnosis.  My balance nerve had to be severed (ok they call it sacrificed  ;D) due to my tumor placement.  I walk without aid but at times am wobbly. 
My headaches are minimal compared to what I had previously to treatment.  I do find when I over do it I wake up with one so am learning my limits and find I hate rainy days.  I can usually get rid of the headache with ibuprofen or fiorcet.

Hope that helps,
M

nancyann

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Re: retrosigmoid approach at House
« Reply #2 on: November 01, 2006, 01:14:26 pm »
Hi there, I had the restrosigmoid approach (not at house) for a 2 CM AN - I must admit, once I got home from the hosp. 4th day post-op, the headaches started, & they were NASTY!!!!.  I wasn't a headache person before, but this was hell for about 1 week, pergatory for about 2 weeks.  The problem was I can't take opiates, only used xtra strength Tylenol every 6 hours.    I also have right sided facial paralysis - this is NOT the norm - my tumor really did a job on the facial nerve.  I have total deafness right ear, my hearing was about 80% prior to surgery on the right.    Remember, all outcomes are different, most ANers don't get facial paralysis, it depends on size, tumor placement and damage to the nerve.  I wish you all the best, Nancy
PS:  still having balance issues & just started balance therapy.  The balance problem was really bad at first, but it is much improved since surgery (6/19/06).
2.2cm length x 1.7cm width x 1.3cm  depth
retrosigmoid 6/19/06
Gold weight 7/19/06, removed 3/07
lateral tarsel strip X3
T3 procedure 11/20/07
1.6 Gm platinum weight 7/10/08
lateral canthal sling 11/14/08
Jones tube insert right inner eye 2/27/09
2.4 Gm. Platinum chain 2017
right facial paralysis

Jim Scott

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Re: retrosigmoid approach at House
« Reply #3 on: November 01, 2006, 01:44:40 pm »
meh:

No House statistics but for what it's worth:

I had the Retrosigmoid Approach surgery to remove a 4.5cm AN - not at the famed House Clinic in Los Angeles but 3,000 miles to the east at the Hospital of Saint Raphael in New Haven, Connecticut.   My neurosurgeon (Dr. Ike Goodrich) and his highly experienced surgical team did a fine job.  I didn't have any headaches following surgery, which was performed almost 5 months ago.   However, pre-op, I had lost my hearing and I don't expect it to 'come back' - but one never knows.  Otherwise, I'm almost back to normal, now.  My balance is good and I never experienced any facial paralysis, thank God, so that was not an issue for me.  What few lingering AN symptoms I still have are very minor and easily ignored or compensated for, when necessary.  I expect that even those will eventually resolve themselves, in time, as usually happens with AN symptoms that are not immediately resolved, post-op. 

Based on my personal experience and with hearing preservation a concern, I would have to recommend that your husband seriously consider the Retrosigmoid Approach for his upcoming AN removal. 


Jim
4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.

suelay

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Re: retrosigmoid approach at House
« Reply #4 on: November 01, 2006, 10:33:15 pm »
I had retrosigmoid and have basically the same hearing in my L ear as I had before the surgery.  I was lucky.  It is why the most-experienced doctors I consulted with recommended retriosigmoid approach.  I have enough hearing that it was worth trying to save it.  I had late onset temporary facial weakness a week + after my surgery.  That has almost resolved after only a few weeks.  Everyone is optimistic that ithe remainedr will go away soon.  I do not have any balance or headache problems.  The left side of my head often feels strange but not painful. 
L AN 16 x8 x8 mm
Retrosigmoid at Mayo Clinic Drs. Link and Driscoll on 9/25/06
Very good result

Featofclay

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Re: retrosigmoid approach at House
« Reply #5 on: January 06, 2007, 07:35:52 pm »
After reading all of the posts here and doing extensive research on my own, my husband and I have made the decision to go to Los Angeles for my surgery.  Dr. Rick Friedman, Dr. Marc Schwartz and Dr. Michael Stefan of House Ear Clinic have stated the retrosigmoid surgery is the one I should have.  My AN is on the right side 1.7 x .8 cm and I still can hear really well with my right ear.  Hopefully, they will be able to preserve this for me.  My surgery date is February 16, 2007.  I don't know what to expect as far as how I will feel after the surgery.  I have not read any of the posts on Post Treatment so guess that's where I will start next.  Jean from Mississipppi 
Diagnosed 12/19/06; 1.7 cm x .8 cm right side
Retrosigmoid 2/16/07 @ House Ear Institute
Dr. Rick Friedman, Dr. Marc Schwartz & Dr. Michael Stefan
Excellent results

Obita

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Re: retrosigmoid approach at House
« Reply #6 on: January 06, 2007, 08:31:38 pm »
Dear Jean:

Good for you.  Making the decision is the hardest part.

Please write to me if you have any questions at all. 

Good luck to you, Kathy
Kathy - Age 54
2.5 cm translab May '04
University of Minnesota - Minneapolis
Dr. Sam Levine - Dr. Stephen Haines

FlyersFan68

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Re: retrosigmoid approach at House
« Reply #7 on: January 11, 2007, 09:31:23 am »
Has anyone had surgery with retrosignmoid approach at House Ear Institiue? How was the result?

Does it cause severe headaches?

How is the result with facial and balance nerve?

is there a chance to loose hearing with ritrosigmoid approach as we have heard that with retrosigmoid we can save the hearing.


When I had my surgery in 04' there was speculation that bone dust may cause post op headaches so I mentioned this to my surgeon prior to surgery. A few months after surgery I had some head/neck pain but headaches are not an issue for me at this point at nearly three years following surgery.

It is my understanding that balance nerves are always sacrificed due to the fact that most AN's arise from one of the two vestibular nerves. Severing the balance nerve is needed to remove the entire tumor in most cases. It also allows the opposite side to fully compensate over time ( days, weeks or months).

Retrosigmoid may save hearing but depends on your hearing going in and the size and location of the tumor. Tumors that arise on the inferior balance nerve (like mine) have a decreased chance of saving hearing. Tumors arising from the superior branch have a higher chance of hearing preservation but is not guaranteed. These are just some things I've learned along the way during my own research a few years back. Please obtain actual stats form the surgeons themselves. HEI will fax you information regarding all the approaches.