Keyhole surgery at John's Hopkins

[texas_109]

Hi all - I recently found out I have an acoustic neuroma and am looking into treatment options.

I came across this http://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/brain_tumor/center/acoustic-neuroma/ and was wondering if anyone had knowledge of this procedure? Is it just marketing for a regular Retro-Sigmoid Craniotomy or is it using newer less invasive techniques similar to the SBI?

Thanks!

[caryawilson]

Keyhole.. Sounds as if it's a small hole. I had this approach at Hopkins for a 4.5 cm AN.  The "keyhole" was 5 cm.

At Hopkind, I understand their are normally only two neurosurgeons that perform the major AN: Dr. Lim and Dr. Tamargo. I had Dr. Lim and he was amazing and the staff was amazing. "keyhole" is a modified retrosigmoid approach based on the location and size of the tumor. I know everyone advises on the Trans to preserve the facial nerve, but one of the lessons I learned was to let the surgeons do their preferred method. I don't want to tell then they are wrong since I read the internet. They are operating every week..

By the way my facial nerve was severed due to the vascularity of my tumor which caused lots of bleeding during surgery. Trans or retro, I was going to lose my facial nerve. My AN was too big, too vascular, and too much damage on this nerve.

. In the end . no headaches and great recovery

[Sheba]

So far I have chatted with just one neorotologist, have more meetings next week.

The one I spoke to said if we do surgery, it should be retrosigmoid for my case.

He mentioned the "hole" size they would make is generally between the size of a quarter to a half dollar.

5cm = 2 inches = about half dollar or larger.

Maybe most surgeons now do retrosigmoid with a hole about this size.

I believe the guy at Skull Base Institute is doing something different - totally endoscopic, meaning he cannot actually directly see the area he is working with his eyes, he is using cameras and a computer screen.   That's what others are saying is a concern, he can't really see if the surgery causes a small bleed to happen, which can be big trouble later.

Probably Hopkins is doing regular retro microsurgery, and just emphasizing that the entry hole is small ish.  I am sure you can call and ask them.

[MSchmit]

Dr. Lim and Dr. Carey removed my AN a couple weeks ago. Coincidentally, I asked Dr. Lim about the  keyhole approach on the website. He said he doesn't like to use it because of the limited view it provides of the facial nerve. He did the regular retrosigmoid approach. I realize that doesn't answer your question about what the keyhole approach is or why they advertise it on their website,, but thought I'd share.         By the way, I can't say enough good things about Dr. Lim and Dr. Carey and the level of care at Johns Hopkins. I did lose my hearing in that ear, but it was anticipated beforehand.    I have had no complications. I'm two weeks out from surgery and I have to be careful not to overexert myself. I feel like I'm almost back to my pre-surgery strength level.