Treatment Options > Microsurgical Options

Where to go--suggestions for AN surgeons?

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Director:
ANSydney,
  The ANA Medical Advisory Board is aware of this study AND has several notes of caution, including this response:1. This article is a review, and to critically understand a review, it is important to have familiarity with the source material.
2. We all have some biases as to what we think, and while we all clearly recognize bias toward surgery or radiosurgery, I would suggest that the Denmark group has a bias toward observation. Their whole academic interest and reputation is based upon this.
3. The definition of tumor growth used by the Denmark group is very liberal. For instance, they do not consider an intracanalicular tumor to be growing until it grows out of the IAC; that is, a tumor that grows in the canal from 3mm to 8mm is still in the non-growing group.
4. Looking at references, they cite studies showing high rates of non growth without making it clear that these are very selected groups of patients. These selected groups are not representative of all patients diagnosed with ANs. For example, see reference 16, from the House Clinic.

Having said all that, we do see patients with non growing tumors, so obviously some do stop growing. The trouble is knowing which ones these are.

An experienced physician with good judgement may be able to select which tumors can be safely followed, even if they are initially growing slowly, with the hope that growth has a good chance of stopping.

On the other hand, for one patient to generally encourage other patients to disregard doctors’  advice to treat growing tumors with the expectation that growth will probably stop is in my opinion dangerous. This is a very one-sided reading of a very complex literature.
I encourage all patients to explore to the fullest all treatment options.
Allison

tonyc:
Paganini,

The size of AN is a factor. Its position and other factors are also very important. The Dr. in House recommended surgery must have his argument. The Drs in House had been in this field for many years. Each individual case can be very different. Choosing a particular approach all depends on your judgement.

Dr. Brackmann is very experienced and knowledgeable. He answered all my questions and relieved all my concerns before and after the surgery. He and Dr. Marc Schwartz did middle fossa on my AN in March 2016. From my footnote, you can see my results.

One thing I want to remind you that Dr. Brackmann is an ENT doctor. A neurosurgeon is equally important and sometimes can be more critical for the surgery. Dr. Schwartz is a very famous neurosurgeon and he is about to do his 2000th AN surgery. But he left the House and is in UC San Diego with Dr. Rick Friedman.  Dr. Lekovic in House is also good and you can find cases mentioned in this forum. I didn't meet him personally and can't tell much. Whoever you choose as your doctor, you need to build trust with them.

paganini:
Thank you, all, for this valuable information. I sent my MRI to House and am waiting to hear from them. I will continue to update and question as I hear more. I’m sure I will have many more questions...

SusanMC:
Hello Paganini, I realize it's across the country for you, but I highly recommend Dr. Manuel Ferreira at University of Washington Medical Center in Seattle. He is the Chief of Neurosurgery, and Acoustic Neuromas are one of his specialties. I am 6 weeks out from having a 4cm tumor removed. It was a complex operation because it affected 8 cranial nerves, and I am really thankful for the approach he took. In doing my research, he really is top-notch. If you're not able to travel to Seattle for the surgery, perhaps he or his staff could recommend someone in Miami. Good luck!

SeattleAN:

--- Quote from: SusanMC on January 09, 2018, 11:09:46 pm ---Hello Paganini, I realize it's across the country for you, but I highly recommend Dr. Manuel Ferreira at University of Washington Medical Center in Seattle. He is the Chief of Neurosurgery, and Acoustic Neuromas are one of his specialties. I am 6 weeks out from having a 4cm tumor removed. It was a complex operation because it affected 8 cranial nerves, and I am really thankful for the approach he took. In doing my research, he really is top-notch. If you're not able to travel to Seattle for the surgery, perhaps he or his staff could recommend someone in Miami. Good luck!

--- End quote ---

Hello SusanMC,

I am also from Seattle, and my husband recently discovered AN. We are seeing Dr. Ferreira on the 30th. Would you share the experience with him as your surgeon? We would love to learn more about him. Thank you in advance.

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