Survey on Surgical Hearing Preservation

[kill_bill]

thank you Captain Deb and battyprincess for your concern

yesterday we went to another one neurosurgeon. he arranged meeting with the best surgeons in the best clinik. But just because country is not big, this kind of tumour is not so often dsiagnosed as in US. they said they had only one girl 17 y.o. during last year, but about 30 adults per year. They said, that the problem is that his hearing will become worse in left ear after operation, an at this size of tumour, they will protect his facial nerves. So me and mom for now became steady more 
they said that operation can wait while he will finish his school semester this end of june, because its very slow growing tumour.

[Battyp]

Yes typically  it is a slow growing tumor so waiting until the semester ends shouldn't be a problem.  His hearing will become worse in his left ear if you don't treat the tumor too.  What type of surgery did they suggest?  with Middle Fossa or Retro there is a chance that hearing can be perserved but I think in all cases saving the facial nerve is the most important thing. 

Hug your mom for us and telling will sending good thoughts your way! 

[Captain Deb]

Anyway, back to the subject--still wanting to hear from anyone who actually ended up with any hearing at all after surgery.

Capt Deb

[Battyp]

you know I think if the tinnitus would dimish I'd have more hearing!  It's so loud it blocks stuff out

[Desilu]

Hi Deb,

Middle Fossa was the approach and I only lost 10% of my hearing. I was told that my tumor was on top of the 3 nerves and was easy to remove. I feel truly Blessed! Ann

[Captain Deb]

Jeez, I'd say so!  Something to be said for surgery on a small tumor! You are really fortunate indeed.
Capt Deb

[Janet]

I did not have any additional hearing loss after my retrosigmoid surgery. I had 75% hearing on my AN side and still have 75% hearing after surgery. The doctor said I had a 50% chance of loosing my hearing as a result of the surgery. I have constant and fairly loud tinnitus both before and after surgery. My balance nerve was sacrificed. The tumor was "sticky around my facial nerve", but I did not experience any facial paralysis. Headaches were the main problem before and after surgery. They increased in frequency and severity after surgery.

[vcschaub]

I had middle fossa surgery for a small tumor (6mm). My hearing was 100% when I was first diagnosed, my symptoms being fullness in the ear and balance and dizziness problems. After 1 year, my hearing had diminished to 85%, which made me decide to have the surgery. My first hearing test after surgery was 2 months later and my hearing was at 76%. Six months after that it has held steady at 76%. Hearing in my "good" ear is still 100%. I was very fortunate.

[tony]

I was talking with Majid Sammi (he of 3,000 AN OPs, Hannover Institue)
He explained how delicate the hearing nerve was
"hearing is OK, everything is fine
 then you touch the wrong place
-and its gone - just like that"
I would add that the size/location is also significant
Best regards
Tony

[Sue]

Just had my hearing tested on Monday.  My audiologist wouldn't give me a percentage like I've seen on this site.  She just said that most AN patients test in the "Profound Hearing Loss" area and I tested in the "Severe Hearing Loss" area.  Shoot, I was wanting to throw around those percentages too!  Had no speech recognition on the AN side.

Sue in vANcouver.

[suelay]

Still very early, but appears hearing was spared at almost pre-operative levels--which is pretty good--word recognition, no high frequency hearing.  I understand that you need to be about 3 months post-surgery for the information to be very reliable.  I also understand that the smaller the tumor and the less hearing loss to begin with, the greater your chances of preserving hearing (mine was 16 mm x8mm x 8mm). I was also told often to expect to lose  meaningful hearing and am glad for that advice as it does seem more common than not.  I will post again after 3 month mark. 

[Chris]

This is possibly going to sound silly but..I can understand how surgery can result in loss of hearing. If I had 50% hearing before radiation and now nothing, is that because the AN works it's way into the ear canal and damages nerves etc?

[Mark]

Chris,

Not a silly question at all.

Prior to either treatment choice whatever damage the AN has done to the auditory nerve through compression of the hair like fibers which transmit sound is generally irreversible.

Loss of hearing through surgery, to your point, is fairly understandable. Sharp instruments around cranial nerves the size of a thread can have that effect. Unless the AN is very small , generally 1 cm or less, I have not seen studies that have shown a high percentage of retained usable hearing with surgery. The larger the tumor the lower the %

Loss of hearing with radiosurgery is less common, but definitiely can occur. The facial and hearing nerve are generally both involved in the tumor and will receive some of the radiation dose. while the healthy DNA of the nerves should recover better than the abnormal DNA of the tumor, they can still be impacted permanently. One dose treatments such as GK are ususally around 60-70% hearing preservation based on recent studies I've seen. FSR protocols such as with CK where staged treatment spreads the dose generally track slightly higher. those who don't maintain the pre-treatment levels may have some additional DB range loss, but only a very small percentage lose all their hearing

Mark

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15918941&itool=iconabstr&query_hl=21

[Chris]

Thanks Mark, you always seem to be a good source of information and I love to see ideas backed up by statistics not just scare factor. Can't wait to see how things progress with me. If I have lost my hearing for good, so be it. I would love to get rid of the tinnitus though, which I was told would be in the 30% mark.