Endoscopic proceedure

[davjack]

Hi I haven't been on in a while and I was so excited to see this that I didn't even check the archives...is this for real? Am I seeing this right? An endoscopic proceedure for AN exists? http://www.skullbaseinstitute.com/
Loree

[Jim Scott]

Loree ~

Good to have you back.  Yes, endoscopic surgery is being used for AN removal, albeit in a limited way, so far.  It may be the wave of the future (for AN removal) - or not.  Time will tell.

Just type 'endoscopic' in the 'Search' bar and you'll be directed to lots of posts about endoscopic surgery for acoustic neuroma removal. 

Jim

[captoats]

Hi Loree, I've been lurking here for some time and have been researching SBI and Dr. Jho in Pittsburgh, both whom have some experience with this procedure.  I was recently diagnosed with a 1.4 X 1.7 cm alien on my right side.  Kind of knew I had something for the past 10 months when my symptoms started one morning. Typical tinnitus and slight reduction in the high frequency's but no balance or facial issues.   

I had a Cyber Knife consultation today and have a consult with Dr. S at SBI soon.  Dr. Jho and House just got my stuff so I'm doing my best to make the best decision I can.  Dr S. has taken some flack from the good old boy neurosurgeon club over the years for not being a ordained neurosurgeon, but if you look what he has done with endoscopic tumor removal, its pretty impressive.  Matter of fact, he just submitted, according to his office staff, a 500+ patient study for review in some medical journal.  I'm supposed to get a copy of that tomorrow and will certainly post whatever I can.

As you probably know from the wealth of information on this site, making the decision on a plan of attack is probably the toughest decision we face.  For me, in good health and with good hearing, keeping as much of that as I can and mitigating as many of the unintended consequences of treatment are high on my wish list.  Once the choice is made, the skill of the treatment team and luck determine the outcome. 

[jerseygirl]

Hi,

It would be great if you can post the study. I would be curious to read it, as I am sure is the case with many others on the board.

I had my second surgery at SBI and very happy with the results. I have to caution you, though, that it is brain surgery just like any other. It does have a lot of advantages, but the side effects can be exactly the same and it might not even work out, also like any other surgery. The word "procedure" implies that it is somehow less than "brain surgery" but ,in my opinion, it is not, although it is overall simpler to perform. I would call it "endoscopic method of tumor removal" and you would have to consider it along with traditional methods or radiation.

                    Eve

[captoats]

Hi all.  I have the 500+ patient report from SBI in PDF format and if someone can tell me how to attach it, I will.  I'll copy the text and post it as a separate post.

I had a consult with Dr. Shahinian at SBI the other day and one with Dr. Brackmann at House.  I have to say I'm impressed with both of these men.  House has done 7,000 the traditional ways, and SBI has done about 600 endoscopic resections.  Because I am a pilot, radiation and the unknown response of the tumor is a little troubling to me and the FAA.  The wait time after Cyber Knife to see what you have and don't have seems to be a issue for the FAA aeromedical guys and it might take a long time to get a first class medical again after radiation. Plus the fact that it's still in there and may or may not become a problem down the road.  Dr. Brackmann has published a pretty thorough brief on radiation that should be a must read for anyone figuring their options.

I'm leaning towards the endoscopic approach for my situation.  I've done a ton of research and reading about the various approaches to these pesky critters and it seems that the endoscopic approach might become more common as more surgeons get familiar with the instruments and protocol.  I am told that the instruments used are custom to skull base tumor removal and are extremely expensive so that might be why there aren't more done this way.   I was given names of former patients at SBI to correspond with and so far, I haven't found one that had a negative experience with Dr. Shahinian.  One was a vascular surgeon; comforting that another surgeon took this approach for his own AN.  A little more due diligence and I'll be ready to pull the trigger.  I only hope my insurance company isn't going to be a problem.  Seems as this procedure costs about as much as a house in some parts of the country. Yikes!

[leapyrtwins]

Seems as this procedure costs about as much as a house in some parts of the country. Yikes!

captoats -

conventional AN surgery ain't cheap either.  The cost of most AN surgeries start in the area of $100,000.

Jan

[Gus]

Thanks for the information on the SBI.  Have you decided on an approach yet?
My local Dr. had had not positive feelings about SBI, but would not go into detail.
I also had a phone consult with Dr. Shahinian and his method seemed to be the real deal.
I don't want to have my balance nerve cut unless it is absolutely the only way via surgery.
I'm 54 and the long term effects of radiation concern me.

Do you believe the SBI is the real deal?
 

[leapyrtwins]

Gus -

in most cases having your balance nerve cut isn't a big problem.  The body naturally learns to compensate for the loss, in fact for some with large ANs their body has been compromising for quite a while without them even realizing it and without any treatment (surgery) whatsoever.

Jan