Schwartz vs Lekovic

[ccooper]

I see hundreds of posts on Schwartz at House, but not much recently about Lekovic. Any thoughts?

[UpstateNY]

I chose Dr. Schwartz since he had by far the most recent experience with ANs, the best outcomes (which he shared with me), and answered all my questions most thoroughly.  He even provided me with his personal email and mobile number for any questions at any time.  This is just my opinion, but no other neurosurgeon came close to his credentials and integrity.

A few posters of this forum were treated by Dr. Lekovic, so hopefully they can provide their personal experience.

[UpstateNY]

Yes, Drs. Schwartz and Lekovic are the only neurosurgeons at the House Clinic.  I believe they can be partnered with any neurotologist.   Drs. Slattery, Brackmann, etc. are neurotologists, so they perform the opening and closing, which is a bit more than assisting.  Although removal of the tumor is probably the most critical part (which is what the neurosurgeon does), the opening/closing is really just as important since you want to avoid infections, headaches, CSF leaks and other complications.

Translab provides the best view of the tumor to minimize facial nerve damage, but does not preserve any hearing.  Middle Fossa may provide the best possibility for hearing preservation.  You should discuss the pros and cons of each with your physicians since each case differs.  Also, many factors can contribute to the recovery time, but the general rule of thumb is that the smaller the tumor is the quicker the recovery.

I would certainly recommend you ask to speak with Dr. Schwartz for a neurosurgeon.  My personal opinion was that Dr. Brackmann was a bit senior, but my understanding is that he is a very good physician with a vast amount of experience.  I and many others have had a very good result with Dr. Slattery.  There is no reason you can't speak with all three.

[gedavis]

Thank you so much for the quick response.  I understand it better now.  I will call up there and see if while there on Friday we can speak with the others as well. 

[mcrue]

I chose Dr. Schwartz since he had by far the most recent experience with ANs, the best outcomes (which he shared with me), and answered all my questions most thoroughly.  He even provided me with his personal email and mobile number for any questions at any time.  This is just my opinion, but no other neurosurgeon came close to his credentials and integrity.

A few posters of this forum were treated by Dr. Lekovic, so hopefully they can provide their personal experience.

I agree. Dr. Schwartz and Dr. Slattery are very impressive. They would have been my team had I elected microsurgery instead of Gamma Knife.

[Cheryl R]

Every dr has their own protocol but I do know Univ of Iowa does mid fossa on 1.5 cm.     I think not more than that.    Mid fossa can also depend on tumor location also.                  Cheryl R

[Sheba]

Docs at House invented middle fossa; other docs now are experienced/competent with that approach as well; if House tells you middle fossa is not recommended for your husband, I would tend to believe them. 

If he has serviceable hearing, and wants to keep it, I think at a competent place like House or Keck, the bad long term headache stories for retrosig are not relevant - it sounds like they know what to do to avoid that (i.e using special foam when drilling bone; techniques to close the skull properly etc.).  Also patients should do stuff to massage their neck and incision site to reduce scar tissue post op.  this may be something not well communicated to patients.

whether to have it out or wait&watch - that is the very tough decision.
I have 1.4 cm tumor, am flying to Keck next week for retrosig surgery.
My rationale  - mish mash of:
- don't want to give it chance to get larger and harder to remove or cause more trouble
- am 54, surgeries are harder as you get older / don't want to wait;  dura in particular becomes more delicate (not sure what age tho on that)
- have good insurance and good health now
- have decent hearing still, hoping it may be preserved by the surgery

My dad had cancer at an early age so I am not so keen on radiation but would consider it if I have regrowth later.

Still I don't think you should rush your decision based on moving.  Once you are comfortable with a decision, you could always fly back to LA (if your insurance covers LA docs), and / or there are very good AN surgeons in some other cities as well.   

I am a little jealous that LA patients have those guys locally - I am a little afraid about flying home and then possibility that complications may follow.  But I am accepting that risk.