minimally invasive approach (SBI) for WHICH kind of ANs

[neuroma_racer]

so i am on page 6/16 of the microsurgical threads,
looking for everything about ENDOSCOPIC approaches i can find.

have read quite a few long threads by sharonov, but cant quite tell if she went with SBI or not.

i know Ixta did, and his was larger than mine,
i know allegro17 did, not yet familiar with her case,
i know acabitz was asking a lot along these lines, but dont yet kno0w what was decided.

so here's the question . . .

any idea to what degree endoscopic surgery is aim at CPA area ANs, vs IAC ANs???

thanks,

i have seen teh SBI website, alrady
and have Dr Jho's pulled up, but havent yet perused it.

thx,
jesse

[opp2]

The majority of microsurgery requires endoscopic surgery, however I think you are looking at Dr. Shahinians site at the Skull Base Institute. Sharanov has not gone for surgery there. I was posting with her just recently. I think she's back in watch and wait.

The difference with Dr. Shahinian's technique is that, as the video shows, they begin with a small hole and then gradually 'stretch' it so that if accommodates the microsurgery tools. The same tools as most micro surgeons use. The one thing I've heard from one surgeon I spoke to about this very technique is the issue of brain bleeds and accessibility. Traditionaly microsurgery has  a 'larger' opening so easier to access any arteries that happen to get nicked during sugery.

A second concern raised was that Dr. Shahinian has not published any thing related to his technique. No studies, no comparison results, nothing negative etc. Maybe there hasn't been a negative result, however he's published nothing either way. Nor has he published anything related to his technique.

A third concern is that Dr. Shahinian is a trained cosmetic surgeon, not a neuro surgeon. Of course neuros may be a little jealous of their territory, however last time I checked cosmetic surgeons were also MD's so they do have medical training.

**anyd way.....this is only what I have read. I too considered going this route, have no doubt about that. My decision was made from the above. I have been unable to locate any studies from Shahinian or SBI. I wish there had been. I truly do.

[neuroma_racer]

yes, i think i'll change the title on the op if i can,

teh question is really whether one type of tumor location or another is better suited for minimally invasive approaches such as SBI's

[opp2]

Oh I wouldn't know for sure but I think he does all his AN surgeries that way regardless of location.

[opp2]

oh, and Good Morning. 

[leapyrtwins]

Racer -

as I recall, Sharonov did not go with SBI.  I think she went with House or decided to watch & wait.  If you PM her I'm sure she'll respond and tell you for sure what she ended up doing and why.  I also think that she may not have an AN, that it might have been a meningioma or facial neuroma, but I'm not positive.

I read your other post about thinking that surgery may now be your best option. 

All I can tell you is my own experience.   I had an excellent outcome with retrosigmoid; my only permanent side-effect is SSD; I opted for a BAHA.  Surgery isn't as scary as it seems and you tend to forget the particulars by the end of the first year - at least I did.  The early days are definitely something you wish you could miss - you pretty much feel like you've been blindsided by a Mac truck - but after that, recovery is generally fairly swift.  Personally I wouldn't be too concerned about your racing career, if AN patients can standup paddleboard and run marathons post op I think that speaks volumes.

As far as SBI & Dr. Shaninian go, those who have had endoscopic surgery there are very happy with their results.  I still subscribe to the theory that endoscopic is the wave of the future for AN removal - not yet tried and true enough for my taste.  But that's my opinion and you obviously need to make your own decision.

Jan

[leapyrtwins]

Racer -

just found this post from Sharonov - guess she's still watch & wait.

http://anausa.org/forum/index.php?topic=10022.0

Jan

[ppearl214]

jesse

allegro (Laura) had AN surgery at SBI last April (I believe).  Please do a "search" option from the forums home page for allegro's posts.  she recently updated us on her situation.

Phyl

[rupert]

    Maybe I'm missing something here.  How does a cosmetic surgeon have credentials to do brain surgery?   I assume you have to have a certain amount of training and licensing.   Apparently so if so many have gone there.    Just asking,   I don't want to deter anyone from persuing what they feel is best for them.   Bryan

[opp2]

Cosmetic surgeons are physicians so they have training in surgical procedures. I'm not sure what his credentials are, only what I've read on the internet. I've never called there to speak to them.

[leapyrtwins]

Maybe I'm missing something here.  How does a cosmetic surgeon have credentials to do brain surgery?   I assume you have to have a certain amount of training and licensing.   Apparently so if so many have gone there.    Just asking,   I don't want to deter anyone from persuing what they feel is best for them.   Bryan

Great question, Bryan.  I don't know the answer.  One of the "rules" of acoustic neuromas is to find someone who is qualified, and has lots of experience, in treating them.  So, anyone seeking treatment with any doctor should follow this "rule".

We have had several forumites go to Dr. Shaninian, so I'm assuming he is qualified and experienced.  However, anyone thinking of going to SBI for treatment should obviously make sure that is the case.

Jan

[eronrabun]

Hey guys -

  For what it's worth, here's my 2 cents:

Please read my other posts as well that give the background.  Long story, short - my husband had an acoustic neuroma (the size of a small egg) removed by Dr Shahinian at Skull Base Institute in LA.  His surgery was on 10/31/05.  5 years ago (WOW!)
I try to come on this site and give periodic updates as to his long term condition.  Everything with the surgery went amazing.  Dr Shahinian and his staff are absolutely incredible!  My husband continues to have VERY FEW side effects.  He has lost complete hearing in his left ear, but he has ZERO facial paralysis or other related nerve issues.  We actually went skiing a couple of weeks ago.  He did comment that he felt his balance was about 85%, but considering it was MAJOR BRAIN surgery - we still feel very fortunate!

Regarding Dr Shahinian's history & publications - my mother-in-law has a "high profile" (for whatever that's worth) job in the health care industry.  She was able to research Dr Shahinian much more than I.  From what she found, Dr Shahinan was trained under Dr Fish from Switzerland.  Dr Fish is a leading neurosurgeon in the world and only trained a small handful of physicians on this procedure.  She was also able to find very few complains from the hospital associations.  There were no major negative findings - that we could find anyway.

I'm giving you all of this from 5 year old memory - so I may have left out a few details - but I CAN tell you that if I had to do this over again .. I would absolutely make the same decision!

Good luck to all of your out there suffering with this terrible condition.  I wish all of you the very best with whatever care you decide.  As I have mentioned in several past posts, feel free to contact us with any questions.  I know how difficult and mind boggling this can be.

[sgerrard]

Maybe I'm missing something here.  How does a cosmetic surgeon have credentials to do brain surgery?

No one said Shahinian is a cosmetic surgeon.  Plastic surgery is not just cosmetic surgery; it is also very demanding facial reconstruction surgery, involving removal of tumors from the face which are close to sensitive nerves. That's what Shahinian was doing. It is actually excellent preparation for removing acoustic neuromas.

When doctors refer to Shahinian as a plastic surgeon, they are intentionally taking a cheap shot at him, hoping their listeners will draw the wrong conclusion. It is conduct unbecoming a physician.

Steve