Pros and cons of surgical approaches?

[leapyrtwins]

I chose retrosigmoid so there would at least be a chance of saving my hearing and I'm sorry I did. 

Rich -

sorry to hear of your post op issues, but I'm not sure I'd blame them on your doctors.  Docs aren't Gods, they are humans and they can't guarantee any of us "issue-free" outcomes.  I'm sure your docs did their best and were honest when they told you about their other patients' experiences.  Everyone is different; we all experience different things.  I was the first of my doc's AN patients to experience double-vision post op.  If I had known enough pre-op to ask him about double-vision, he would have honestly told me that he didn't have any patients who experienced it.

I chose retrosigmoid in the hopes of saving my hearing and I lost that "gamble".  While I grieved my hearing loss, I know for a fact that my neurotologist felt just as bad - if not worse about this - as I did.  I am fortunate enough not to have headaches associated with my surgery and my life (now with a BAHA) has moved on normally.  I know many people who had retrosig and have headaches, but I know just as many people who had translab and have headaches. 

While I totally agree that anyone contemplating AN surgery needs to make sure they have experienced, qualified doctors it's important also to keep in mind that experienced, qualified doctors can't guarantee you anything 100%.  People on this Forum will argue that the docs @ HEI are THE best, but even they have translab patients who experience horrific headaches.

My point here is, everyone is different.  Life can be a crap shoot.  Good docs are a must when it comes to AN surgery, but sh*t still happens.

Best,

Jan

[mk]

Jan has made some very good points.

Generally different doctors specialize in different procedures. From what I have seen on the forum, there are very few doctors who really specialize in middle fossa (like the HEI doctors, Dr. Gantz etc). This is a very difficult surgery, I wouldn't let a surgeon who does not have a proven track record perform this procedure on me.

As for translab, vs, retro, many times it also depends on the neurosurgeon. My hearing was pretty much gone before surgery so it was not a consideration. 2 out of the 5 doctors I saw recommended translab. 2 recommended a combination of translab and retrosigmoid. The 5th does almost exclusively retrosigmoid and he is very good at it, with an excellent track record. I chose the 5th, not because I preferred retrosigmoid (like I said I had not hearing left), but because I trusted his expertise.
as Jan said, there is no guarantee, the  best thing that we can do is to research the credentials of the surgical team, make sure we know what their outcomes are (and I am not talking just "stats', but real patient outcomes) and then hope for the best.

Marianna

[jaylogs]

I had 3 different opinions done, two were all for doing trans lab, one for doing Middle Fossa...understanding that I may lose my hearing anyway, I went with Middle Fossa and I had some preservation, although 2.5 years post it has gotten a bit worse...I can hear out of it, but word discrimination is pretty bad.  I went to House and Dr. Brackmann/Schwartz did the procedure.  I am not suffering from any post surgery issues so all is good!  One difference between retro and MF I believe is that MF they do the procedure more in front of the skull, while retro is in behind? Or was that trans lab...either way, MF is definitely more forward.  Also, they have to cut a Jaw muscle to get to it, so that was one aspect of my recovery I had to work though, getting my mouth to open wide again!  
Jay

[LizAN]

Somewhere I saw a diagram that show the various entry locations on the skull.  It may have been the ANA literature.