Author Topic: Is any hearing better than none?  (Read 3098 times)

allegro17

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Is any hearing better than none?
« on: February 13, 2009, 12:08:35 pm »
Hi everyone.

I am considering treatment options.  I currently have no serviceable hearing on my AN side.  No word recogntion.  I happened to have lost my midddle range frequencies, whch are the speech-related ones.
However, I am not completely absolutely deaf on that side.
I wonder, if I have translab, will I tell a deifference in the minimal amt. of hearing I have no, which is of no use to me, as opposed to complete deafness on that side?  The reason that I ask is because most docs look at my auidograms and immediately reccommend translab, but there is one who says that it is his philosophy that something is always better than nothing, and he thinks that with the way my particular AN looks, I may be able to keep what little hearing I have left, and he would prefer to do retrosig as opposed to deciding to sacrifice the hearing outright.  He says HIS results with retrosig and the facial nerve are at least as good as, if not better than with translab.
I am confused.  Facial nerve is absolutely by far and away the most important thing to me.  However, I tend to agree that I would rather have 2% of my hearing rather than 0%, as long as no additional risks would be introduced.
 

jerseygirl

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Re: Is any hearing better than none?
« Reply #1 on: February 13, 2009, 12:36:53 pm »
Hi, Allegro,

I also believe that some hearing is better than none. People who had no serviceable hearing could usually localize sound and felt more confused with single sided deafness. In addition, an intact (but not working) auditory nerve can be somehow augmented if you really need it, even if in the worst case scenario, it means a cochlear implant.  Retrosigmoid approach in skilled hands can be better or at least just as good in saving facial nerve. Many people on the board, including myself, are a living proof of that.

The real issue here is if you have a cochlear neuroma, like one surgeon suggested. If you do have it, then its growth would destroy (maybe, already destroyed?) any hearing (including hearing anatomy) you have left. Then it makes no sense to have retrosigmoid, save your remaining hearing and facial nerve and then later have translab to get rid of cochlear neuroma. If I understood correctly, it is on the same side? If they are on different sides, then it is worth to go after any type of hearing preservation you can get.

                 Eve
Right side AN (6x3x3 cm) removed in 1988 by Drs. Benjamin & Cohen at NYU (16 hrs); nerves involved III - XII.
Regrowth at the brainstem 2.5 cm removed by Dr.Shahinian in 4 hrs at SBI (hopefully, this time forever); nerves involved IV - X with VIII missing. No facial or swallowing issues.

allegro17

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Re: Is any hearing better than none?
« Reply #2 on: February 13, 2009, 12:50:47 pm »
They are on the same side.  My neurotologist said that the ocurrence of a completely seperate neuroma on the cochlea would be rare, and that IF it is anything it is probably a extension of the current tumor.

If it were a cochlear neuroms, or if it is just an extension of the AN, would a surgeon still be able to get to that by retrosigmoid?  This speck is visible in, literally, one picture out of the hundreds on the MRI.  I know translab would take away any concern about it, but am wondering if it could be effectively recognized and removed via retrosigmoid, too.

jerseygirl

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Re: Is any hearing better than none?
« Reply #3 on: February 13, 2009, 01:02:23 pm »
I really don't know the answer to this question. You would have to ask the surgeon because during retrosigmoid they can't possibly go into your cochlea, damage it during tumor removal,  and save your hearing at the same time. Damaged cochlea means no hearing, from what I understand. I can be wrong, of course. In addition, if the cochlea is damaged but hearing nerve still remains, would it be possible to get a cochlear implant at a later date? I don't know the answer to that either. I really think a consultation with HEI would be very beneficial at this point. They do all approaches, cochlear implants and the rest.

          Eve

 
Right side AN (6x3x3 cm) removed in 1988 by Drs. Benjamin & Cohen at NYU (16 hrs); nerves involved III - XII.
Regrowth at the brainstem 2.5 cm removed by Dr.Shahinian in 4 hrs at SBI (hopefully, this time forever); nerves involved IV - X with VIII missing. No facial or swallowing issues.

Syl

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Re: Is any hearing better than none?
« Reply #4 on: February 13, 2009, 01:49:25 pm »
Allegro:

I retained some hearing after my retrosig surgery. My word recognition is at 20%. Unfortunately, I'm not a candidate for a BAHA because I have too much hearing left. A BTE hearing aid doesn't do a whole lot for word recognition--it just amplifies the noise.  So if you're considering some sort of hearing device after surgery, please ask your Drs. and audiologist what you may or may not be a candidate for before you decide on your treatment choice.

Is your word recognition at 2%?

What size is your AN? One Dr. told me that he prefers retrosig surgery for larger tumors. So it could be that retrosig results in higher facial paralysis cases than translab because of tumor size and not necessarily the procedure itself.


Good luck,
Syl
1.5cm AN rt side; Retrosig June 16, 2008; preserved facial and hearing nerves;
FINALLY FREE OF CHRONIC HEADACHES 4.5 years post-op!!!!!!!
Drs. Kato, Blumenfeld, and Cheung.

Jim Scott

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Re: Is any hearing better than none?
« Reply #5 on: February 13, 2009, 02:39:24 pm »
Laura:

Unfortunately, by the time I was diagnosed, my hearing nerve had been irreparably damaged by the acoustic neuroma.  My neurosurgeon chose the retrosigmoid approach, not to save my hearing, but to get better access to the tumor.  I'm pleased to report that I had no facial nerve damage from the surgery and no paralysis.  I've been SSD for about 5 or more years, now.  I cope fairly well and it's more of an annoyance than anything else. 

I'm not certain if 2% hearing is actually useful but I wouldn't mind having it, so we share that philosophy with the doctor who wants to use the retrosigmoid approach surgery.  I can understand your confusion when doctors offer conflicting opinions on what surgical procedure is best for you but I would opt for preserving facial mobility over - possibly - saving a tiny bit of hearing that may not even be of any practical use.   Of course, the decision is yours to make as you think best and we'll support you in whatever your choice turns out to be. 

Jim
4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.

texsooner

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Re: Is any hearing better than none?
« Reply #6 on: February 13, 2009, 03:08:29 pm »
Allegro, my opinion is that if the surgeon has a good track record and is as successful with the facial nerve using the retrosig procedure, then I'd lean that direction (everything else being equal) as there is no possibiity to save any hearing with translab. In my case, I was not that concerned with losing hearing because I thought mine was pretty well shot on the AN side before surgery. Even though I did have the retrosig procedure(surgeons call because of tumor position), I still lost 100% of my hearing on that side. Turns out that I probably had more ability to hear some on the AN side before surgery than I gave myself credit for....because I notice a difficulty that I've had to adjust to(post op) in recognizing what direction some sounds are coming from. In any case, I believe, some hearing(even 2%) is better than zero.

Patrick
3.5cm left side AN; 11 hour retrosigmoid surgery 8/11/08 @ Memorial Hermann, Houston - Texas Medical Center with Drs. Chang and Vollmer; home on 8/13/08;
SSD(w/tinnitus); dry eye; Happy to be here and feeling good.

 


anything
anything