not sure where to post

[lora]

OK--I am a postie from my translab but now facing a sub-occipital on Tuesday.  Pretty soon I should be a pro at all approaches, no??  That is my question now--can anyone give me insight, advice on this new approach?  The old once bitten,twice shy?  The first time I just went into it stupid, because what did I know?  Having been to this rodeo once, I want a little foresight this time.  That old pesky tumor on the brainstem and all.  I am trying to keep my sense of humor, but frankly I am starting to feel like "Brainzilla".  They are already talking about the GK for the remainder and I am not thru the second one yet.  I realize the thisnthing as HUGE and I thank God everyday that I have a chance to live, but come on!!!  How about some words of wisdom, encouragement, hope, advive guys  

[Raydean]

Hi Lora

Your right, you will be an expert by the time you're done.  For what it's worth my husband had a second surgery too.  For him the second time around was alot easier.  ( but by then we were "smart enough to place him under an experience medical team)  Follow up radiation treatment  is often suggested as a follow up, especially if the tumor is large.  Know that you will be in my prayers and thoughts.  It takes alot of strength and courage to face this again.  The first time we worried about the whole event.  The second time because we knew what was to be made it more difficult to face. Your strength of spirit and courage will see you thru.  The valuable knowledge that you gained thru this will be of great service to others that will follow.  if I can be of any help please feel free to email me anytime. 

I'm enclosing a description of the sub-occipital, both the advantages and and disavantages.

Hugs to you
Raydean

Suboccipital 
Suboccipital is an approach behind the mastoid. The advantages include the following. There is a large exposure of the cerebellopontine angle, an advantage for removing large tumors compressing the brainstem and cerebellum. The rate of hearing preservation for all sizes of tumor in our series is better than with any other approach. The rate of hearing preservation for tumors confined to the internal canal ranges from 65 to 85% (comparable to the best results reported for middle fossa surgery); tumors extending out of the canal but without brainstem compression from 25 to 45%; and tumors compressing the brainstem about 15% (largest tumor with hearing preservation is 3.5 cm). Proponents of translabyrinthine surgery state that facial nerve preservation is better with that approach; however, in our series facial nerve preservation is as good as with the translabyrinthine approach. We have been able to preserve the facial nerve in all patients with tumors less than 3 cm, and in 90% of patients with tumors 3 cm and larger.

Disadvantages include the following. The cervical muscles must be separated from the subocciput to gain exposure. Muscle pain following surgery is common. One estimate is that 50% of patients will be experiencing headaches at six months after surgery, 25% at one year, and 10 to 15% at two years. Patients with muscle tension headaches prior to surgery are more likely to have headaches after surgery. "
 

 

 

[eugd]

where are you planning to do the second procedue? how big is the other tumor? and do you have time to look around for a doctor that feels comfortable opening up your head in a diffrent spot, some doctors may want to use the original crany spot.