Middle Fossa Approach

[RE]

OK, Here goes, This is my first post so bear with me.  I had the Middle Fossa approch done 7 weeks ago this thursday.  I had Levine and Haines at the Univesity of MN perform the procedure.  I was diagnosed with the 6x5x5 mm AN in March and waited until work died down in the fall to have it done.  I had a leak form and they had to open the lumbar drain for the leak to heal.  I was in the worst pain I had ever been in for 3 days after that drain was opened.  I was released from the hospital on Day 8 and off all pain medications by day 12.  I have not had any headaches since the drain was closed five days after it was opened.  I have had no other problems to date other than minor balance issues and fatigue.  I actually was back in the office 1/2 days 2 weeks after surgery and have been in every day since after Thanksgiving.  My hearing was in the top 2% prior to surgery, I go in next week for a test.  I currently have some rininging in the AN ear and don't hear very well out of it to date.

I decided to do this approach after extensive research, visiting the surgeons at both the U of M and the Mayo Clinic and hannging around this web site.  My wife was not so upbeat on this approach due to the additional risks with the facial nerves.  I am apparently one of the lucky ones who has not had any facial issues.

The one thing I can say regarding this approach is make sure the surgeons have perfromed a lot of this approach.  (Haines and Levine had done around 80, while Drisco and Link at Mayo had only done around 20.) 

Good luck and stay positive!

P.S.  I am the worlds worst speller so I apoligize.

[marg]

Hi,
I had a middle fossa surgery on May 14th  of this year at Oregon Health Sciences University (OHSU).  My tumor was very small (3 - 4 mm ) and Dr. Johnny Delashaw was my neurosurgeon.  I chose this surgery because I had an 80% chance of keeping my hearing and I didn't want to keep wondering if the tumor was growing all the time (as I would have with radiation).  I could have wait and watched for a while but I had already started losing the higher range of hearing in that ear and knew the longer I waited the more hearing I could lose (slowly or all at once) and that after the tumor reached a certain size they could no longer do a middle fossa (which was my best surgical chance at keeping my hearing).

     This is my post surgical outcome:  I did lose all my hearing in the AN ear within 6 weeks ( the doctor said the nerve could have stroked after surgery.... he was very surprised I had lost my hearing although he had warned me it could happen), I have some facial paralysis (they had to scrape the tumor off the facial nerve) and they did take my balance nerve with the tumor (less chance of it growing back .... and other 'stuff' too). 

      Now 7 months after surgery my balance is really pretty good  - I can walk up and down stairs without clinging to the banister, I can carry 2 bags of groceries at a time  and I have never fallen ...although I do lose my balance and recover it (on occasion).  The facial paralysis is better and continues to improve  and I am back to work full time teaching.  I am still tired (okay...so part of that is because of working with 25 2nd graders every day) but feeling more energy as time goes on.  I have no mental or memory problems and as far as headaches go..... I have no more headaches now than I did before  - except for migraines which for me I get because of stress (my mom and dad are in their 80's and have had many severe health issues lately) ... so migraines are up from 1 a year to about 4 in the last 7 1/2 months.   I also attribute this to not having as much emotional / physical energy because of the day to day challenges with being single sided deaf and working in a very noisy fast paced job.  After looking at the outcomes of many other people on this web site.... I think my outcome was a good one and I am very grateful  for life and the ablility to continue to teach (even though teaching now is much harder than it was before). 

As has already been said... everyone's outcome is different ...just as our tumors are all different.  The surgeons really don't know exactly what they will be dealing with until they get in there.  If I had gone to House Clinic .... would I have kept my hearing and had no facial paralysis I don't know and will never know.  House Clinic has their share of cases that have less than great outcomes too.  Often it has to to with the position of the tumor and how things go.  I researched my options, my neurosurgeon does hundreds of craineotomies (sp?) a year and over the last 20+ years he has done hundreds of Acoustic Neuroma surgeries.   I wish I would have been one of the ones with a 'perfect happy ending'  and come out of surgery with everything the way it was presurgery except for a scar - but the truth is I have only met one person who has had that result. 
I wish you well as you decide what to do ........... take the time to sort things out and interview more than one doctor before making your decison.... I did and I'm glad I took the time.  I'm scared to even think what the outcome would have been if I had gone with the first doctor.
Margaret

[marg]

RE   ... I hope you end up with some of your hearing left.... as I said ....I did have hearing after surgery but at the 6  week hearing test all usable hearing was gone ( I only heard noise when the hearing guy talked very loud in the AN ear headphone ) ... then within a few more weeks lost the rest and now I  hear nothing at all .
Margaret