You have hearing preservations yet you have hearing loss. Interesting conundrum.. Would you be counted as "preservation" or a "loss" person..
And, that begs the question of how much hearing has to be lost in order to be considered a "hearing loss" statistic?
See, as a newbie and watch & waiter, this is where I spend my time.
As a newbie, I have been seriously challenged by the mysterious inconsistency of research around acoustic neuromas. While I will spare you all the details that confuse me, I will address this one from my perspective
and my range of limited research. I would appreciate any guidance offered on understanding this stuff!
I did google this physician - and he published a research paper about ANs and hearing preservations in 1997. I admit a long time ago - but it is all I could find. It also only addressed a small population of ANs - about 60 where either the middle fossa or retrosigmoid was done - the 'hearing preservation' surgeries. So, while the 1200 is thrown around - and don't doubt the doctor has done that many (or many more) - this study by this physican had a small population. I will put the link to the 'summary' below.
Here is a short piece, relevant to this discussion of that study.
This report reviews acoustic neuroma outcomes of individualizing the surgical approach to patient and tumor characteristics. This study reviews 60 consecutive hearing preservation acoustic neuroma surgeries in a total series of 330 acoustic neuromas. Tumor sizes ranged from 0.3 to 4 cm in patients ranging from 23 to 74 years of age. Middle fossa surgery was performed in 57%, retrosigmoid in 43%. Overall, measurable hearing was preserved in 77%, and useful hearing in 67%. Among middle fossa cases, 85% had measurable and 74% had useful hearing. Among retrosigmoid surgeries, 65% had measurable hearing and 58% had useful hearing.
I would assume (never a great thing) that the stats quote by Lisa are based on this study - 85% had MEASURABLE hearing. This is an obviously different therm than useful hearing. As I break down middle fossa:
15% - have no measureable hearing - in my words, if they stood beside a lawn mower at 90db, the wouldn't hear it.
11% - have 'measurable' but not useful hearing - that infers that they hear between 50db-90db (i.e. PTA) and understand between 5%-50% (discrimination) of words at that db. (some lack of distinction because if your PTA is 55db but your discrimination is 85% you still have meaurable but not useful hearing ... still figuring that one out). As a benchmark - 60db is 'normal conversation'.
74% have useful hearing - which divides into 2 categories the 0-30db and >70% discrimination and 30-50db and >50% discrimination. It would be very useful to have more of a breakdown in that department but that isn't available in this piece (or in many other pieces either - alas one of my pet peeves).
Again, as many have mentioned, there are so many conditions that affect the ultimate outcome. In broad strokes, I believe that middle fossa is principally (but not exclusively) for small ICA tumors which, in general, by defintion have superior hearing than the larger CPA tumors .
So, I would suggest that dog lover (CAthy) and Lisa were part of the majority who maintained useful hearing, and more than likely based on their descriptions, easily fit in the Grade 1 class of <30db >70% discrimination - which is utterly awesome!!!
I have read a few House papers as well (again, only the summaries - so rather limiting) and their 'rates' are lower - but the one study I read had a much much larger patient population than this study. And, while I was far from a star in my college stats course, would suggest that the 85% of measurable hearing versus I think about 68% at house is potentially statistically insignificant. Just a guess - but when you have 57% x 60 patients (i.e. 34 patients) versus 151 patients, that stats will be more indicative at 151 patients. I know there a few scientists on this board so challenge away at my stat assumption.
Someone else brought this up - it is my understanding that translab is focused towards ANs that are large and where hearing preservation isn't a goal (either because of poor hearing pre-op or a large tumor where hearing preservation isn't likely). I have gandered that translab (and please correct if incorrect) that this is the least likely approach to have other complications - facial nerve, headaches etc. so if hearing preservation isn't part of the goal, this is the best approach.
I am a newbie with a small ICA tumor who is watching for now (gosh, I am getting impatient though - I don't think I will pass this watching crap!) so am learning a lot.
I am also Cdn and not willing to foot the bill for a bit trip to a US doctor - so will be sticking to the Cdn scene. I am not concerned that I won't find an excellent surgeon (if that becomes my choice) here whose rates are comparable to either Fukushima or House.
Fukushima - Research study:http://www.biomedexperts.com/Abstract.bme/9261005/Individualizing_hearing_preservation_in_acoustic_neuroma_surgery
House - Reserach study - middle fossa:http://cat.inist.fr/?aModele=afficheN&cpsidt=2820310
PS - because I just have to vent - what the heck is 'actuarial' assumption on radiosurgery - frig, I see no place in 5 year 'actuarial' tumor control rates - if the technology has been around for 30 years, get REAL STATS PLEASE!!!! Sorry - had to vent.