House Ear Clinic is clearly one of the premier places to pursue a surgical removal of an AN in the world. However, I have always had the opinion based on the erroneous information on their web site and other articles that they were very anti radiosurgery and would steer people to surgery in virtually any situation. Thus I would tell folks if you are sure you want surgery, strongly consider HEI, but if you want to get an unbiased opinion on both options , then go somewhere else and talk to someone who actively does both.
A few months ago, HEI announced that they now had access to a GK in their host hospital , St Vincents. This created some discussion that they were becoming more open to radiosurgery as a viable option. Being the skeptic that I am
, I found it hard to believe that leopard could change his spots that quick, but allowed that could happen. Personally, given the number of people opting for radiosurgery, I assumed it was just a ploy to give some credibility to their recommendations. Something along the lines of "yes, we do have a GK, but in your case we still think surgery is preferable".
I've been anxious to hear the first person who called HEI and in fact as told that GK was the choice. However, I saw the attached post on the CPSG site yesterday that suggests to me that my skeptical view is probably correct. The link to the exchange which includes a response from Dr. Medbery and some other posters ishttp://www.cyberknifesupport.org/forum/default.aspx?f=16&m=10839
for those who would like to read the whole thing, but the specific recap of the discussion with Dr. Brackman isI am speaking with Dr. Brackmann again at House Ear Clinic in LA. He continues to insist that my concerns are unfounded at their facility. He assures me that none of his patients have ever experienced anything other than mild facial weakness and that none of them have had facial disfunction to the point of the eye not closing with an AN the size of mine. He feels that the risk of the radiation not working and the "salvage" surgery being more difficult and having poorer outcomes outweighs the increased risk of complications for the surgery vs GK. He was vrey opposed to fractioned radiation. I honestly do not know what to do. I don't have a lot of time to research, but I have been doing what I can as I can. I have concerns about FSR because I read you can only have it once. I had read before that you can have GK after GK. I am not certain if I am correct on that but I would lean toward GK over FSR if it is an all or nothing deal. I know I need to make the research a higher priority as it grew 1mm in four months. I don't want to wait until I have hearing loss to make a decision but everything I read is very conflicting. Dr. Brackmann said unless I was in my 70's he would not recommend GK since there are no good statistics beyond 20 years and my life expectancy is longer than that. I told him I would prefer 20 good years to 40 with my face paralyzed. He simply is very confident I will not have a problem. Unfortunately he is working on mine and I am still very nervous about it. I also really don't need to be out of work for a month - assuming there are no complications.
Any new insight would be greatly appreciated!!!
Sure doesn't sound like a physician who has embraced radiosurgery as a primary solution for AN treatment does it. So until I see some other evidence I would still encourage folks not to view HEI as a place to get a balanced view of both options. Otherwise, it sure doesn't look like the leopard has any new spots