Author Topic: 1.4 CM AN, 60% Hearing remaining, Surgery or Watch and Wait??  (Read 2888 times)

Pain in the Aspirin

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1.4 CM AN, 60% Hearing remaining, Surgery or Watch and Wait??
« on: September 15, 2021, 11:59:43 pm »
Hello Everyone:

Thank you so very much for your assistance in advance.  My girlfriend has a unilateral 1.4 CM AN tumor in her inner right ear close to the brain.  I am writing on her behalf because she is an English student.  It seems to be an AN, but small chance it is Facial Nerve tumor.  Girlfriend has lost 40% of hearing in her right ear so far.  She has pretty strong tinitus, she says it is like a rumbling sound, pretty constant.  No facial nerve paralysis or facial symptoms of any sort.  She had one MRI about nine months ago and a second one 30 days ago.  The size is unchanged, but they noted her hearing fell by 20% in that time frame, from 80% down to 60% remaining. In the past two weeks, she said she might possibly have felt a small bit of occasional dizziness.  She seems to balance fine and never has to grab the walls to balance.  The doctors predict a 40 to 50% chance of losing all hearing in right ear after surgery.  So they have about a 50 to 60% chance of saving her current hearing in the right ear.  Left ear is normal.  Conversely, they predict she will lose all hearing in right ear within one to four years if she does nothing.  Three out of four neurosurgeons want to do a Middle Fossa approach.  But they are reluctant on recommending doing surgery or watch-and-wait.  They say they "could do surgery for the preservation of hearing" but leave it up to her.  Based on the above, would you recommend surgery or watch and wait?    Thank you again. 

Greece Lover

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Re: 1.4 CM AN, 60% Hearing remaining, Surgery or Watch and Wait??
« Reply #1 on: September 16, 2021, 11:54:34 am »
Sorry to hear your girlfriend is in the club. You'll find people will advocate for various positions here, and one of the weird thing about these tumors is that there are such wide options for what to do/not do! I opted for Middle Fossa surgery.  Here was my reasoning:
1. While surgery cause immediate risk of losing all hearing, it also gave the best chance at long term hearing preservation. My hearing was a little better, and my tumor a little smaller (1.2 cm) so I was told about 60% chance of saving my hearing, which is thankfully what happened.
2. I wanted the tumor "out."  I recently had my five year follow up MRI and everything looked good, so I don't have to go back. I don't have to worry about  recurrence, etc.
One important question is to ask how often the doctor/surgeon does middle fossa surgery. it's important to have a surgical center who does AN tumors as often as possible.
Good luck!
Vestibular Schwannoma 1.2 cm. Right side.
Middle fossa surgery at University of Iowa on May 9 2016.
Hearing saved.  Face is fine. Balance pretty darn good most days.
One year follow up MRI showed no tumor. 
Five year follow up showed no tumor, so I'm in the clear.

CA Marti

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Re: 1.4 CM AN, 60% Hearing remaining, Surgery or Watch and Wait??
« Reply #2 on: September 21, 2021, 01:17:11 pm »
Sorry to hear of your girlfriends problem. That's great news that it's not growing. If mine wasn't growing I would definitely watch and wait. There are many risks with surgery and I personally don't think it's worth it especially if it's not growing. As you said, there is also a risk of losing your hearing with surgery. Why would they think there's a chance of it being a facial nerve tumor, is it because of the placement? I believe if there is any facial nerve involved then surgery is even more risky to your facial nerve. Best of luck to you and it's always a good idea to get multiple opinions from different surgeons.
Marti


Diagnosed 5/28/2020  10.5mmX8.5mmX6mm
Next MRI   11/22/2020 10mmX8mmX6mm

Pain in the Aspirin

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Re: 1.4 CM AN, 60% Hearing remaining, Surgery or Watch and Wait??
« Reply #3 on: September 29, 2021, 12:27:54 pm »
Thank you for those replies.  We are struggling with making our decision.  But now, she stuggles a bit more with dizziness, especially after a long walk or exercise.  So this is another motivator.  After we took a two-mile walk, she had to lay down for a few minutes because she felt waves like she "was on a moving boat".  So if the dizziness continues, and for hearing preservation, we might go forward with surgery. 

 


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