Author Topic: House vs USC vs NYU Langone  (Read 4320 times)

beninBK

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House vs USC vs NYU Langone
« on: March 22, 2017, 03:14:41 pm »
Hi all, 

I was diagnosed with an acoustic neuroma on 2/15 (9.4 mm in spine 5mm CC Tr x 10mm Ap X 6.5 mm CC).   For some background, I woke up on 2/3 with severe hearing loss, I saw and ENT who prescribed steriods.  My hearing improved significantly about three days later and has stabilized there . 

I live in NY and have seen many doctors here. I''m pretty set on surgery over radiation at this point for many reasons. I was leaning towards getting surgery with Dr. Thomas Roland and John Golfinos at NYU langone, I thought they were great and was pretty much set on going to them. They recommended rertosigmoid.   

Over the last few days I had phone consults with Brackmann at House and Friedman at USC. Both recommended middle fossa for a number of reasons but mainly they felt it gave the best chance of hearing preservation. 

I think all of these options are great and everyone on this board seems to have nothing but great things to say about all of these doctors.   I live in NYC so all things being equal I would prefer having the surgery here but I am now leaning towards flying out to LA to have the surgery done. The fact that both Friedman and Brackmann seemed pretty sure that middle fossa is the way to go scared me a little. 

Any advice/experience greatly appreciated. 

MarlaB

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Re: House vs USC vs NYU Langone
« Reply #1 on: March 22, 2017, 04:59:04 pm »
Welcome to the club no one wants to belong to. If you feel comfortable with Dr. Roland (who I personally think is awesome) ask him if he would consider middle fossa..and why or why not. It's good to have your surgeon be available (and close) for follow up.

Dr. Friedman is equally awesome. I know of a few people who have had Retro-and have kept their hearing.

I hope this helps. Good luck!!

Marla

ANSydney

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Re: House vs USC vs NYU Langone
« Reply #2 on: March 22, 2017, 05:38:56 pm »
Hi bebinBK and another welcome to the club nobody want tot be a member of, but everyone is friendly.

Your dimensions of "9.4 mm in spine 5mm CC Tr x 10mm Ap X 6.5 mm CC" appear odd; for instance is "in spine" a mistype? There are four linear dimensions without any of them being identified as ML. Regardless, the largest dimension is 10 mm, so your tumor is small.

In other countries, tumors smaller than 15/20 mm are conservatively managed in 95% of cases.

What is your objective? If you want to keep your hearing for as long as possible, conservative management is the way to go. ( https://pdfs.semanticscholar.org/2cef/abe8e8eef1ae32cab8bcf3c71dd75f53387c.pdf and https://www.ncbi.nlm.nih.gov/pubmed/18559028 ).

My current favorite quote is from Dr Michael McKenna, in the video at https://www.anausa.org/resources/videos/support-group-video-library. The quote is, “The best treatment is no treatment, if you can do it”.


bird33

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Re: House vs USC vs NYU Langone
« Reply #3 on: March 24, 2017, 06:55:40 am »
Hi BeninBK,

I am 3 months postop from my surgery with Dr Friedman/Giannotta at USC.  I  fortunately have had the dream outcome and recovery.    I also had hearing presevation with retrosigmoid approach and have no headache concerns as well (some mention this as a possible downside of this approach which is likely overstated with modern techniques at high volume centers). 

As a practicing surgeon I, like everyone else, was interested in not only having a surgical outcome free of complications, but wanted to get back to work asap!  Luckily, i was able to do that in 4-5 weeks and was at full speed within 8 weeks. 

I discussed having middle fossa with Dr Friedman and he recommended against it for my tumor based on size and location.  My point is he will recommend the approach that is best for your specific situation in his hands, and, like in my case, will not do it if he feels it isn't "right".  For whatever reason, I was hoping for middle fossa as I suspected recovery would be quicker, but he did not feel it was right for my particular tumor.   Luckily, it turned out perfectly well with retrosigmoid!

I can only speak about my experience which was obviously very positive.  I am better than i was before surgery and been that way for over a month now.   As many say, go with your gut and do what feels right.  good luck and if you want to speak about my experience in more detail please contact me directly.  Take care 




beninBK

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Re: House vs USC vs NYU Langone
« Reply #4 on: March 24, 2017, 08:54:49 am »
Thanks everyone, 

AN Sydney - given that I already lost a fair amount of hearing and then regained some of it with steroids, I don't think watch and wait is a good approach for me. I would like to at least try to preserve my hearing.  Also I am 38 y/o, so would like to at least take a chance to have the surgery and be done with this.  I understand that might not be the case after surgery but I think it's worth a shot. 

bird33 - nice to hear your story.  Any reason why you chose USC over house? 

bird33

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Re: House vs USC vs NYU Langone
« Reply #5 on: March 24, 2017, 08:00:20 pm »
I chose to go to USC because of the comfort I had with the surgical team.  After speaking multiple times with Dr. Friedman and the coordinator Kris, I felt at ease with their approach and experience.   Also, consistency in the OR is very important, something I am very familiar.   I felt at ease that Dr. Friedman always worked with Dr. Giannotta, allowing for what I felt would lead to more consistant outcomes and Shorter operative times. 

I suspect if you go to House you will find similar success, so I would ultimately choose what feels most right to you.   Certainly they have incredible surgeons at House, but i suspect dr. Schwartz works with multiple ENT specialists.  That mattered to me in a small way, but ultimately I just felt good about my decision to go to USC for my surgical care.   if you are deciding between House and USC you are going to be in experienced hands.   


beninBK

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Re: House vs USC vs NYU Langone
« Reply #6 on: March 27, 2017, 05:09:16 pm »
Thanks Bird, makes total sense.  I have spoken to kris a few times and she is fantastic.  It's a tough call, I think you're right in that i just have to trust my gut at some point.  I'm leaning towards house at this point, mainly because the Neurosurgeon is the one actually removing the tumor and, based on this board,  Dr. Schwartz seems to be the man. 

riabovamd

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Re: House vs USC vs NYU Langone
« Reply #7 on: March 27, 2017, 09:29:20 pm »
I had mine out 1/24 by Dr Schwartz and Dr. Slattery. They can do surgery with their eyes closed- they introduced mid fossa,  do 3-4 of them a day and train surgeons from all over the world. You will be in good hands at House! Good luck!

bird33

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Re: House vs USC vs NYU Langone
« Reply #8 on: March 28, 2017, 09:53:00 pm »
Agree.  If you are deciding between House and USC feel good about your decision.  Middle Fossa also, in the right hands, can actually be a relatively shorter operation, leading to quicker recovery.  I believe Dr. Friedman often performs these in one to two hours, so I am sure with that approach your results will be that much more predictable.  Good Luck and keep us updated on your progress!!