permanent facial paralysis

[peterlee]

I have scheduled surgery with 'sub-occipital approaches' of my AN next month. The size of my tumor is 2.1cm x 2cm.
I being told by one surgeon with the chance of 'permanent facial paralysis' is about 8% but another doctor I consulted said the permanent facial paralysis won't happen but instead is a transient facial paralysis (temporary) and usually recover 3-6 months.

Anyone would give me a objective opinion would greatly appreciated.
I currently reside in Chicago area.

Thanks very much.

[Smedina]

I'm leery of absolutes.  Permanent facial paralysis is an unfortunate risk of surgical intervention.  Any surgery (even with the best surgeons)  can present unwanted risks and complications.  Generally, absent any issues, today's surgical techniques seem to do a good job of preserving the facial nerve.  But even if it's preserved, temporary paralysis or weakness is still a risk.

Best of luck next month.  Hope you have an easy recovery.

[Doc]

Nothing is absolute. You should be prepared for some level of deficit; short term or otherwise.

[TR4guy]

I find myself hesitant to respond ... because I don't want to bias anyone too much with my own biased opinions.


Questions I would ask of the surgeon(s)

Why take that surgical approach (sub-occipital) vs. other ones?   
What are the pros and cons associated with each approach?

How many times has the team done this type of surgery?
What variants have they done?  (other approaches?)
When do they recommend NOT doing surgery or taking non surgical treatment options?

What is the surgeon's policy regarding leaving any bits of the tumor behind? 
Do they ever do it?
If so, under what circumstances? 

I believe that AN tumors grow on a nerve that affects hearing and balance.
If there is facial paralysis... then another nerve has been damaged.
Is it already damaged before surgery?  Or does it get damaged during the surgery / removal of the AN tumor?

There are other risks too besides facial paralysis. 
What about chronic headaches?
What does the surgeon think the chances are of those happening?

[peterlee]

Thanks so much for all advise.

[alabamajane]

Hi,
Not sure what Drs. You are using in the Chicago area,, but you may want to get a second opinion from other Drs. before surgery. I'm not a Dr. but don't believe it should be said that there is NO chance of facial paralysis with an AN surgery as the facial nerve #7 cranial nerve lies right along side of the hearing nerve #8 that the AN grows on in the IAC ( internal auditory canal). And from what I know and have read,, the Dr doesn't know until he is in there how involved the nerves are. The MRI doesn't give him that much insight. Just my opinion for what it's worth,, not a whole lot! 

I don't know if you are close to Evanston, but Dr Wiet and Battista are in that area I believe and they are VERY good AN Drs. Look them up maybe,,, also, you could send your MRI and report to House Clinic in Los Angeles for a free on the phone consult. I did that several years ago and they are SUPER nice and knowledgable! The location of any tumor also has as much or more to do with outcome as size. So you see, there are MANY factors when dealing with these tumors to take in to account.

Good luck and let us know how it goes,,,

Jane

[peterlee]

Thanks very much for all the info.

[mandy721]

Lots of good advice here.  Damage to the facial nerve is rare, but it happens.  I'm not sure what the correlation between retrosigmoid and facial nerve damage is, but there might be some data in the ANA Patient Survey.