Thinking of Surgery

[tinab]

Anyone out there have middle fossa for a small AN (under 1 cm).  I have hearing loss in my right ear no other symptoms but the hearing loss has happened in the last two months.  Since it is small and I qualify for middle fossa I have a chance to remove and save hearing (fingers crossed). I am scheduled in September with Dr. Friedman at UCSD. Any comments experiences out there would be greatly appreciated.

[ANSydney]

Why not have a follow up MRI to see if your tumor is still growing?

[tinab]

My MRI was in May and no growth then my hearing slowly went overnight. Doctors don't think it is growing just normal wear and tear from the tumor.
Right now I am 47 and the tumor is small and I qualify for the Middle Fossa. I have been told by all doctors that I will in my lifetime have to act on this tumor .  My thought is I am not getting younger and I may be in the best place to do it right now.   UGGHHH this decision is so hard to make. 

[notaclone13]

If I were your age, and considering your hearing is gone, I would want the thing out. Then chances are very great, especially because it is small, that you can get on with your life and not look back. You will have a great surgical team and they do thousands of these surgeries. For an older person like me, radiosurgery is a better option. Older bodies don’t heal as well. But for you, having it removed so it is gone seems the best choice. The important thing is to make the decision you are most comfortable with and go with it.

[gary.s]

I agree with ANSydney, why not wait and see if the tumor is growing when you take your next MRI. This will give you some time to think about your options and make the appropriate decision. Best of luck.

Gary

[notaclone13]

I do agree with Gary.s and ANSydney on one thing, your AN does not appear to be growing at this point. Sometimes they stop growing all together, so you do have time to think before having major brain surgery. In addition, you never know whether a new drug therapy will emerge while you are waiting. 

[ANSydney]

The article at https://www.ncbi.nlm.nih.gov/pubmed/18559028 concludes "An initial period of conservative management is a safe and reasonable management policy in all acoustic neuromas up to 2 cm in size at the cerebello-pontine angle. Given that there are no failsafe ways of deciding potential for growth in acoustic neuromas, initial conservative management of these tumours offers superior hearing and facial nerve preservation when compared with primary surgical treatment."

No matter what you do, your hearing is likely to decline. If you want to minimize the decline, watch and wait has the best results. ( https://pdfs.semanticscholar.org/2cef/abe8e8eef1ae32cab8bcf3c71dd75f53387c.pdf ) In particular, "In the literature, to our knowledge, there have been no reports of the hearing preservation after 10 years or more after hearing preservation surgery or radiotherapy. In the present study [no active treatment], 95 patients had been observed for 10 years or more. According to the AAO classification, 46% maintained good hearing after 10 years or more compared with 45% using the WRS classification and 75% of patients with 100% speech discrimination at diagnosis."

The clear majority of tumors have already stopped growing by the time they are diagnosed. Take a look at the thread https://www.anausa.org/smf/index.php?topic=23404.msg979773646#msg979773646 .

[Jet747]

( https://pdfs.semanticscholar.org/2cef/abe8e8eef1ae32cab8bcf3c71dd75f53387c.pdf )

Interesting study ANSydney...thanks for posting it.

BR,
Jet