Friedman/Giannotta vs. Slattery/Schwartz - any advice would be great!!

[newbie77]

Hi,
I'm trying to decide between these 2 great teams.  My tumor is 1.5cm. Does anyone have any advice between these 2 great teams?

Also, between the surgery methods of middle fossa vs. retro sig especially since my tumor is on the border line.

Thank you so much!

[michellef08]

Hi!
We have had a similar discussion in a thread called "Friedman/Giannotta vs. Brackmann/Schwartz -- any advice needed" very recently. I'm not sure if this will work, but here is the link: http://www.anausa.org/smf/index.php?topic=22193.msg979767523#msg979767523

We were discussing Brackmann instead of Slattery, but you can get the idea.

As your tumor is 1.5cm - this will probably be right on the borderline. Middle Fossa is normally performed on small tumors. I had my Middle Fossa surgery performed at House with Schwartz/Friedman back when they were still together. They thought my tumor was 0.9 cm , but it ended up being 1.4cm. I was so thankful that they were able to perform it though because they preserved my hearing! The main upside of Middle Fossa (as I was told my surgeons) is it has about a 70/30% chance of hearing preservation, vs Retro-sigmoid has a 50/50% chance. As far as I know - the main downside of Retro-sigmoid is the risk of headaches, but as mentioned in the other thread, I'm not sure it applies if you have a very experienced surgical team perform your surgery (like House or Keck).

The best thing you can do is have a free phone consult with the surgeons. Not everyone gets to choose which surgical approach they can have. The surgeons will look at the size, location (in relation to facial and balance nerve and cochlea) of your tumor per the MRI and suggest the approach they think will be best for you. Good luck!

[Circusnole]

Can't go wrong with either one I would think. Both teams are great.  Biggest difference to me was the fact that Schwartz would be the one picking around inside my head for 8 hours. He's simply the best when it comes to microsurgery. I had Retrosig to remove a 2.1x1.7cm tumor and never once had a headache, balance issues, etc... I know each case is different and each outcome as well, but it was so much better than I was fearing. I used to teach Anatomy and Physiology and that made it worse because I spent the weeks leading up to my decision researching everything I could about it. I'm sure you've probably found out by now, no one really has the "this is what you need to do" answer. Each Dr. has a list of several suggestions and each one favors what they specialize in. After the phone consult with Dr. Schwartz, it made up my mind, he explained everything and then I asked him if it was him, what would he do.

Each one has a risk, you just need to go with the one (team) that you feel the best with and move forward. I'm not sure what USC has for recovery but staying at the Seton Hall at St. Vincents hospital (across the street from House) was a great benefit as well. Lots of support /patients there pre and post op.

Good luck with everything,
 

[RetroBoy]

While obviously I can't tell you what to do I can describe my own experience being in the exact same position.

I had a 1.6 cm AN removed via retrosig with the Keck team on 11/2/15 and would describe my experience as mixed. While I don't doubt the Keck (Friedman/Giannotta) team's skills, I think perhaps expectations were not properly managed in my case. We left for California (we live in suburban DC) fully expecting to retain my hearing. When that didn't happen, needless to say we were disappointed. On the positive side, I have no other side effects. No palsy, headaches etc. I had some dizziness but I'm back driving and feel exactly the same, save the fact that I have little to no hearing in my right ear.

Prior to coming to Keck we consulted with Johns Hopkins, Weill-Cornell, Mount-Sinai and the House Ear clinic (Brachmann/Schwartz). With the exception of House, all teams recommended retrosig; House offered middle fossa. On the strength of their skill set and recommendations and the fact that the House and Keck teams were the best in the country, we went with Keck; our rationale being that the Keck team was skilled in both approaches and chose retro.

While it may have been wishful thinking on my part or hearing what I wanted to hear, for whatever reason, the reality that I might lose my hearing (pardon the pun) wasn't fully communicated until the day before the surgery. At that point I had already taken 2 months of of work, arrangements for child care made, neighbors informed etc.  As someone with no symptoms prior to surgery, we (wife and I) were in a tough spot. Although the surgery wasn't an emergency, it wasn't purely elective either. My AN was discovered almost by accident in 2005 when it was 4mm. Since then it had grown, on average, about 1mm per year. We knew we had to do something. 

In the event, we went forward. Aside from the standard recovery difficulties (pain, dizziness) I'm fine at 6 weeks out. Keck, as a hospital, not Friedman/Giannotta was a tad disorganized. Despite sending my entire medical record months before the surgery, none of it was available in their computer system. Dr. Friedman had to rely on what we brought and what we told him. I had been taking medications for something unrelated to the AN and, despite watching 3 separate nurses type my medication regime into the computer, the lead nurse in the post-op ICU said "We have no record of him taking this specific medication." Thankfully, my wife was their to correct the mistake.

In any case, I don't want to deter you from choosing Keck. Their team is very skilled. My AN was very close to the cochlea and so I wasn't (I now understand) a good candidate for hearing preservation.  Please feel free to reach out if you'd need more information.

Best,
Josh

[mcrue]

Newbie77,

Any updates?