Translab vs. retrosigmoid approach

[jimmy r]

I have a recurence and have 2 different opinions on which approach is best for my second surgery (2.8cm). Where can I find statistics on both approaches concerning post operative issues such as headaches and facial nerve damage?

[Jwh]

Hi,

I had the retro surgery on a 1.3 cm AN on 5/16/01.  I just found out that I have a 10 mm regrowth.  I've decided on the Translab approach.  I just want this tumor out once and for all.  From what was JUST explained to me by a few neurosurgeons when they perform the retro there is a "blind spot" and sometimes a small part of the tumor is left behind.  I wish I knew that in 2001.  Anyway, I want the surgeons to have the best view of the tumor for removal this time around. 

 

Jen

[HeadCase2]

Jimmy,
  You can perform some Googe searches and pull research articles from medical journals that list statistics on post-op results.  But keep in mind that the operative approach that a surgeon suggests can be related to how large the tumor is, and what other structures it's pushing on, and by that surgeon's preferences and training.  So any diferences in post-op stats between these two surgical approaches may be due to differences in the types of tumors treated by these two approaches.  The two populations are not the same, so outcomes may not be the same.
  If you're concerned about using the "right" surgical approach you may want to consider getting a second, and perhaps a third opinion from other surgeons who have had extensive experience treating ANs.   These doctors are highly trained, so use their knowledge.  But it never hurts to have a consensus between them.
Regards,
 Rob 

[Battyp]

blind spot? I was never told about a blind spot!  I was told retro gave them the best view.  Of course I also know my tumor was more to the back of my head which I think contributed to the doctors choice of treatment.  I would have to agree with Rob there are a few variables when it comes to treatment and best options.  I would get a variety of opinions. 

All my best!
M

[Yvette]

Hi Jimmy, I am 3 mos post op. Had a 3cm removed at the Mayo Clinic in MN, translab style. My surgeons said that the translab approach gave them the best view of my facial nerve. They told me I would read literature that said results were similar with either approach, but that they personally found that protecting my facial nerve was much easier when done translab style. They could try to save my face and a tiny bit of useful hearing, but it wasn't likely with a tumor that big that the hearing would be saved. So I opted for ssd and preservation of my facial nerves. My tumor was not "sticky," came out easily, and I have complete control of my face:-) No complications, doing really well. Best wishes, Yvette

[Shrnwldr]

I chose translab for the same reason.  My hearing is gone and my equilibrium is not the best.  I wanted the opportunity to save as much of my facical nerve as possible.  And both surgeons said the translab was the best approach for viewing and preserving the facial nerver.  3 weeks and counting!

But I also agree with everyone.  Knowledge is power......  power to make the best decision regarding your health

[neal r. lyons]

hi jimmy- i'm new to the game but here are two webs that were passed on to me:info@medifocus.com
                                                                                                                   www.houseearclinic.com
i hope that they be of some use to you-neal

[neal r. lyons]

i'm still researching both albeit slowly but am trying to place my focus on these areas:
     1) incidence of complete vs incomplete tumor removal relative to tumor size
     2)post surgery headaches also relative to size of tumor
     3)facial nerve preservation- does this mean maintaining the status quo or a reduction of current symtoms such as facial numbness
        including upper mouth and tongue?
                                                           
                                                         TRANSLAB?   SUB-0CCIPITAL/RETROSIGMOID?

[Mark]

Neal,

1) incomplete tumor removal , in my opinion, is not related to either procedure approach, but a function of the skill of the surgeon and the situation presented by the AN
2) Studies are pretty conclusive that suboccipital / retro has a higher incidence of post surgery headaches than Translab primarily because the route rips through more muscle and support tissues
3) Facial nerve preservation tends to be higher with translab than suboccipital  because it tends to better expose it. Trade off is a total write off of hearing since the inner/ middle ear is destroyed in the procedure.

mark

[neal r. lyons]

hi mark! thank you kindly for your feedback!  i'm very thankful for this information highway and am finding it extremely valuable.
thanks again, neal

[eugd]

It all depends on the doctor surgical skills, interview as many doctors and teams as you can.  Ask them a lot of questions. I had 5-6 consultations before I settled for a team, and or place to do my surgery.  Just because you hear a doctor is great or an approach has worked for someone else does not mean its going to work for the next person.  You can tell from a consultation of two if the doctor has a clue or not, and make sure that they are doing the surgery and not some resident learning the procedure on you… that is the best advice I can give it pertains to all approaches.