Skull Base Institute

[sharonov]

Today I have two consults, namely Dr.s Battista and Shahinian. 

The first is Battista, and for that I have to drive and have a regular appointment, as he does not do phone consults.  That annoyed me, as every other doctor I've consulted agreed on having the first meeting by phone. 

I have a phone consult today with Dr. Shahinian, and the main question I want answered regards his statistics.  Hopefully he won't lie or gloss over results.  I'd really like to know how many of his patients end up with the usual bad things:  facial, balance and hearing affects.   According to his clinic manager, the answer is 0, but I know that can't be true.  The only person I talked to regarding this was Boomer (Vickie) who had the surgery and is fine except at night she holds on to her husband's arm due to (minor) residual balance issues.  During the day she's fine, and she had the surgery this February.  Her tumor was small, but what really impressed me was that when she woke up he said, "well you got a two-fer."  He saw that, totally unrelated to her AN, a blood vessel was impinging on her trigeminal nerve, and he put in a little teflon sponge (the usual treatment for this.)  She didn't know that this was the source of the bad headaches she had been having.  The headaches are gone.

I did google endoscopy and came up with Dr. Jho in Pittsburgh, but nobody on this site had heard much about him.  I was hoping to hear from other people who had been to SBI, but have come up with a 0.  I promise that if I decide on this route I'll give a weekly report.

Unless things change radically, I'm looking at early October for whatever I do.  Believe it or not, the Trigeminal Neuralgia is being partially controlled right now by diet.  I still need medication, but have reduced my pills from 5 to 4.  I had been looking at early August but realized I had too many things going on in August (including the AN convention of course!) so will stay a vegan for awhile.  This from a major foodie.
Sharon

[another NY postie]

Sharon,
Did you search on Shahinian on this site.  I just did and found a number of people who went with him...one guy actually has a creative video of his surgery you can see.  I would love to hear about what he says to you today.  I don't think he can possible be operating on 8 AN per week but maybe 8 Brain Tumors as he does others as well.  Just not enough ANs to go around for that to make sense.  I didn't think I would consider this type of surgery but now I am wondering more about it myself.
Cheryl

[sgerrard]

Steve,
What does this mean? When conventional surgery works really well compared to endoscopic surgery working really well, what is the difference?

When there is no nerve damage or other side effect either way, the main benefit of endoscopic is a smaller hole in the head and a shorter operation. Both of these contribute to a faster recovery time. Less invasion and less time under anesthesia are both good things. House, for instance, has documented on their site that middle fossa works best when the time the brain is retracted is kept as short as possible.

Steve

[another NY postie]

That is what I have understood from my research too.  Not that endoscopic is producing better outcomes - his statistics are showing that they are equal to other surgical outcomes in terms of hearing, facial, etc. .  My understanding is that the difference is that you have less hospital stay, and less recovery time due to little hole and less "brain surgery" aspects as I don't think he retract any brain to get to tumor. 

[sharonov]

Cheryl, where did you find Dr. Shahinian's statistics?

[another NY postie]

Sharon,
When someone who went out there to consult with him and told me about him, I googled everything I could find about him (that's when I found out that a lot of surgeons were not happy about his posting).  I am sure I read it when I was reading on him.  I will see if I can find it again.  It is probably SBI saying that - I don't think I probably found actual statistics that were from an unbiased third source but I am going to see as I read a number of newpaper articles about his surgery techniques (kie. cutting edge- saving kids with non AN tumors)
Cheryl

[nteeman]

Steve,
What does this mean? When conventional surgery works really well compared to endoscopic surgery working really well, what is the difference?

When there is no nerve damage or other side effect either way, the main benefit of endoscopic is a smaller hole in the head and a shorter operation. Both of these contribute to a faster recovery time. Less invasion and less time under anesthesia are both good things. House, for instance, has documented on their site that middle fossa works best when the time the brain is retracted is kept as short as possible.

Steve

I would think that these benefits that you mention is what are projected as benefits as endoscopic treatment for ANs is pretty new. These are what is hoped for but yet to be proved. I agree that it all sounds good but that doesn't mean it is so.  The data has to documented over time and then analyzed.  That said, I can understand ones attraction to this approach.

I had knee surgery some 40 years ago, well before they started doing it with an endoscope. My wife had the same procedure with an endoscope some years later.  Her recovery was definitely easier than mine. Today the condition of our knees are the same.(both not great)

I am not trying to say the endoscopic approach is bad for ANs, only that it is yet an unproven success.  I have a friend who had a hernia operation done with an endoscope and due to a mistake buy his surgeon had to have it done again. The second time it was not done with an endoscope and was successful. This does not mean the endoscopic approach is not valid, just that there are other factors.

For me, I wanted to know how many times and how often my surgeon has done this type of surgery and what the results were. This was more important to me.  I was operated on a Tuesday and went home on a Friday -- only 3 full days in the hospital. How much better would it have been if it was done with an endoscope?  I don't think you can say for sure.  Maybe someday AN surgery will be an out-patient procedure, done with minimal intrusion. I certainly hope so but it is not there yet. Until then I think one must do their research and make qualified decisions based on true data not projected results.

Neal