Does Retrosigmoid get all of the tumor out?

[nycnewbie]

Everyone!
Thank you from the bottom of my heart for responding! I really appreciate all of your responses...this is the toughest decision of my life...should i get the fourth opinion from Jhons Hopkins?!
the problem is I can see Dr. Carey on June 2nd. I cannot see his partner/neurosurgeon until end of July...don't if I could wait that long.
Do you guys think Selesnick would be just as good at retrosigmoid as Tamargo at Hopkins?!

[leapyrtwins]

NYC -

oftentimes deciding on your treatment option is one of the hardest parts of the AN Journey.

However, it's a personal choice and no one can make the choice for you.  You have to decide for yourself - after doing your research, of course.

Sometimes getting multiple opinions can muddy the waters a bit, but hopefully things will be clear to you eventually.

The main thing is to go with a doctor who has lots of experience in treating ANs (and in the form of treatment you decide on - surgery vs radiation).

Lots of us here went with our "gut" feeling when it came to a doctor and a treatment option.  This was my course of action and I've never regretted my decision.

Good luck; we're all here to support you.

You'll get there,

Jan

[nycnewbie]

Has anyone had retrosigmoid done with Selesnick or Roland in NYC?

[Pooter]

Has anyone had retrosigmoid done with Selesnick or Roland in NYC?

I knew the bandwagon wouldn't be far behind me.  I took the liberty of cut'n an' pastin' from Debbi's signature:

Debbi - diagnosed March 4, 2008 
2.4 cm Right Side AN
Translab April 30 at NYU with Drs. Golfinos and Roland
SSD Right ear, Right side facial paralysis (temp)


She's had surgery with Roland in NYC and has nothing but the highest praise for him (and Galfinos). 

I'm with others in thinking that you're not too young for radiation in that's something you want to explore.  As Jan said, it's a personal choice (treatment type), so it's okay if it's not right for you but don't let age become a factor for you just because a SURGEON told you that you're too young for RADIATION.  That would be akin to a radiation oncologist telling you that you're too young for surgery.  The two are equally as preposterous, in my opinion.

Btw, welcome to the forum. 

Regards,
Brian

[cjtender]

Hello....I had surgery with Dr. Selesnick on 4/28/09---he removed a 3x2 cm AN on right side doing it restro and removed the whole thing.....he is a great surgeon and really knows what he is doing.....I did consult with Steig first but then due to insurance reason ended up with Selesnick and Gutin team......if you have any questions feel free to pm me

[suboo73]

Hi NYC!  Sorry you had to join this club, but glad you are researching to find answers.

You can see i am in W & W, so i have not had any treatments (yet).  However, i did have a surgical consultation with Dr. Tamargo.
Kim (Zinger 1095) had surgery with Dr. Tamargo.  If you go back to the main page and type in Zinger1095, you can find her posts.
If you have trouble with the search feature, please let me know.

Since ANs are slow growing benign tumors, i hope you will take a deep breath and do your research.
I am also sure there are some great teams of surgeons in the NYC area.

One more thing - i do have to agree with Steve G. - don't rule out any treatment, including radiation, until you have done your research.
Of course, ultimately, the decision is yours.  That's what often makes  this AN journey so crazy!   

It is QUITE a journey for my family - my sister and i are both here.

Take care and keep us posted.

Sincerely,
Sue

[nteeman]

Hi NYC,

FWIW, I had retrosig at Mt. Sinai w Dr. Bederson and Dr. Smouha and they were fantastic as far as results and care. And yes they got it all!

Cheers

Neal

[wendysig]

Hi NYC,

Sorry I am chiming in a little late.

I assume that since House is suggesting middle fossa, you have decent hearing in your affected ear.  With a tumor the size of yours,perhaps House is recommending middle fossawith middle  because they feel they would be better able to fully visualize the tumor with that approach than with the retrosigmoid approach.  Also since your tumor is deep in the IAC, retrosigmoid approach may not allow full visualization of the tumor, middle fossa would.  My doc had planned a middle fossa approach until I had a sudden hearing loss that would have made middle fossa not worthwhile and so I had translab.  Many doctors trained here prefer to use the retrosigmoid approach because it it the approach they use most often.  My doc trained out in California and routinely used middle fossa when attempting hearing preservation.  If you would like to meet him, I'd be glad to pass his information on to you.  I had surgery at M.t Sinai Hospital last July and had a great outcome other than being SSD.

Best wishes,
Wendy

[nycnewbie]

How come you chose Mt. Sinai over NYU or Cornell? Just curious.

Hi NYC,

FWIW, I had retrosig at Mt. Sinai w Dr. Bederson and Dr. Smouha and they were fantastic as far as results and care. And yes they got it all!

Cheers

Neal

[bell]

Hi NYC:
 I had retrosigmoid at the Mayo Clinic Nov.21, 08.  My AN was 1.3cm.
The first doctor I saw wanted to do translab to preserve the facial nerve, but I would lose the hearing and I had only lost 5%.  I was not happy with that answer.
 Second doctor would only do retro because he said the tumor  was too big for MIddle Fossa.  I never asked how it was placed in the canal.  He gave me 60% chance to save hearing and I lost it.  I also have facial paralysis and eye issues.  Hopefully to improve can take up to 2 years.  I was very happy with my doctors at the Mayo.  Disapoointed that I lost hearing, but life goes on...
I can only sugest that you do your research and listen to that gut feeling on what to do.  Everyone has different recovery times but everyone on this forum is so positive.  I will keep you in thought and prayers.
Bell

[bell]

I forgot to add that the tumor was completely removed,
Bell

[dufreyne]

I had the same situation as you in 2008.  Mine was 1 cm long and extended laterally in the IAC.  I was given the same choices.  You've already received good advice.  I'll add my 2 cents.

The lateral portion of the IAC is difficult to visualize no matter what approach the surgeon takes, but is most difficult for the retrosigmoid.  In fact, one paper asserts that you actually can't get to the most lateral portion of the IAC without violating the labrynthe.  My neurosurgeon didn't agree and said that he would simply use a fiberoptic scope to see "around the corner".  When I spoke to the Neurootologist, he noted that the scope has a difficult time distinguishing between the tumor and adjacent tissue.  He strongly recommended the middle fossa approach for a tumor that extends to the lateral IAC. 

I had a middle fossa approach in October 2008.  They got it all (in one piece).  I do have unilateral deafness (my hearing was 100% intact prior to the surgery) and tinnitus.  I have some mild balance issues and occasional fatigue.  I have no headaches or facial nerve weakness.  All in all, I'm doing pretty well. 

Good luck with this decision--you'll likely be fine either way.

Dufreyne--

[jtd71465]

I've may have already told you this on a different thread, but I had surgery with Roland on January 10, 2007.  All inquires welcome via email, PM or phone.

Joe-

[nteeman]

How come you chose Mt. Sinai over NYU or Cornell? Just curious.

Hi NYC,

FWIW, I had retrosig at Mt. Sinai w Dr. Bederson and Dr. Smouha and they were fantastic as far as results and care. And yes they got it all!

Cheers

Neal

I got a great recommendation for Dr. Bederson then my GP and I researched him as well as a few others and his background was very impressive. There were Drs at NYU and Cornell I was also considering. Next I met with Bederson at Mt. Sinai and I liked his plan. That's it.

[leapyrtwins]

NYC -

I didn't mention it in my prior posts, because I didn't want to confuse you even more, but I'd be remiss if I didn't tell you that Drs. Roland & Golfinos have an excellent reputation.

If I wouldn't have had my surgery locally (in Illinois) I would have seriously considered them.  IMO they are among the best in your area.  I'm not at all knocking any of the other doctors you've mentioned, but not every doctor is for every patient.  While I absolutely love my neurotologist, and I have referred lots of AN patients to him, not everyone liked him as much as I do.  Some chose him; some didn't.

Confidence in, and a comfort level with, whoever is going to perform your procedure (whether radiation or surgery) is very important.  If you haven't already found that in  those you've consulted with so far, I'd seriously look into Roland & Golfinos.

Best,

Jan