Questions about 2nd AN surgery for an AN that was removed in 2004 and grew back

[TMK]

Hi.  I'm a (kind of) new member.  I know I at least lurked on these boards years ago (2004) when my AN was diagnosed and I had surgery.  The doctor thought he was able to remove all of it, but wasn't 100% sure.  My last MRI confirmed that it is again growing.  It's almost a cm, so nowhere near as large as it was the first time, before it was removed.  If/when I do require treatment again, I'm leaning toward a 2nd surgery, but I have a few questions for anyone who has had surgery for a recurring AN.

First, should I expect the same balance problems post-op as before?  I still have poor balance, and the worsening of my balance is what finally prompted me to get the long overdue MRI, so I don't expect to come out of it with no issues, but, since I have already compensated some for the damage to the balance nerve, will I have fewer issues with post-op vestibular rehab than before?

Secondly, is there anymore risk of facial nerve damage the 2nd time around?  I did really well with regard to the facial nerve the first time.  Only very slight, very temporary weakness, never noticable to the untrained eye.

Thirdly, and most importantly.  I had meningitis as a complication the first time.  This was by far worse than the surgery itself, although I fully recovered from it.  I am very fearful of getting meningitis again.  Does having this complication the 1st time put me at more risk of having it again? 

I would really appreciate any thoughts or opinions.

Thank you,
Tasha

[MDemisay]

Dear TMK,

In my considered opinion, even though I don't know you, I would explore ALL my options first! Options include:
1. Watch and wait
2.Gamma Knife
3.Cyber Knife
4. Surgery

There are a number of interventions as described above but to have the best possible outcome you must do your research first. Good luck and keep us posted, in my considered opinion, you have found the site that will give you the support you need now!

As others will tell you, the final outcome of the procedure you choose is up to you, you will have to live with the consequences of your choice.

We are interested in whatever your choice is! No one should have to make this decision but we all have in one way or another.

You are among friendly people here! Come back and vent your frustration often! That is the purpose of this forum to share information with you and to hopefully guide you to making your own decision!You are not alone anymore!

Mike

[Jim Scott]

TMK ~

Welcome, although I'm sorry a re-growth is what brought you back to the ANA discussion forums. 

To answer your questions (as best I can.  I'm not a doctor.)

1. - your brain has long since learned to compensate for lack of input from the AN-affected side so balance should not be a major issue, post-op.

2. - There is always a risk of facial nerve damage when operating on an acoustic neuroma. Your doctor should be able to offer a better assessment of the risk to you, specifically, as he has your MRI and the knowledge of how your AN is located. 

3. Meningitis is definitely serious and was very likely contracted in the hospital during your previous surgery.  I doubt that having a second AN surgery makes you any more receptive to contracting meningitis now than you were in 2004.  I would suggest you mention this very valid concern to your doctor and seek reassurances that all precautions will be taken to prevent a repeat of your 2004 (meningitis) experience.

Jim

[CHD63]

Hi Tasha and welcome to this forum .....

I, as well, had my AN surgically removed via retrosigmoid approach, but in 2008 (supposedly 100% removal).  Three years later the spot (which was assured to be scar tissue) we had been watching on the post-op MRIs suddenly was 1.3 cm, representing a 3 mm growth from the previous year.  End of story, I had it surgically removed a second time (but via translabyrinthine) at HEI just about one year ago.

1) My balance was no different than just before the second surgery, although a bit wobbly from post-anesthesia and fatigue causes.

2) I knew there was a greater risk of facial nerve involvement the second time around.  That's why I chose to go to HEI.  I asked both doctors what they would do if the regrowth was on the facial nerve.  They both assured me they would leave a tiny piece, if necessary, to be zapped by radiation if it also began growing.  Dr. Schwartz did a masterful job of removing every fragment of the tumor and scar tissue, without damage to my facial nerve.  I had a teensy bit of facial weakness post-op, but it was all resolved within a couple of weeks.

3) I am not a doctor, but it is my understanding that meningitis is contagious.  Unless you have a compromised immune system and/or are exposed again by some very odd chance coincidence, I would think your chances of contracting meningitis would be no greater than in any situation.

Feel free to PM me if you would like to talk.

Clarice

[Kathleen_Mc]

Your defecates post-op this time will depend on what nerves were already damaged the first time around and what ones get damaged with the second surgery. If during your first OR the balance nerve was severed your balance will not change with this second surgery. If your facial nerve was spared the first time around it will depend if is is spared this time if anything will change this time around etc
Meningitis is contagious and you must come into contact with it to "catch it", unfortunately you did the first time around, hospitals are full of infections, hence there is no reason to believe you will "catch it" this time
Kathleen