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Suboccipital approach:
A high-arching skin incision is made behind the ear (dashed line) that crosses the occipital nerves at the end branches. This incision also avoids deep dissection of the neck muscles and is less likely to cause chronic postoperative headache compared to a straight incision.


"Observation -- also known as watch & wait --
is an appropriate treatment option for patients who have small tumors and whose hearing is stable. Follow-up imaging with MRI should be performed in short intervals (every 6 months). If substantive growth or progressive hearing loss is discovered, definitive treatment is indicated."-- John M. Tew, MD


When the acoustic neuroma showed up in Wayne's life, it knocked softly. Wayne barely noticed it at first. There was a ringing in his left ear and a slight hearing loss. A trip to a specialist and an MRI revealed the intruder's identity. A benign brain tumor less than one centimeter in diameter was growing ever-so-slowly inside his left internal auditory canal.

Although the tumor was definitely present, its irritations did not warrant removal from its precarious location on the sheath of nerves responsible for hearing and balance. So Wayne and his doctor adopted a watch-and-wait approach. Surgery would be postponed, and Wayne would undergo annual screening to track the tumor's growth. Years went by without any further difficulties, and Wayne forgot about the screening. Then, one day, Wayne found himself having trouble with his balance. He returned to his specialist and had another MRI. "The waiting is over," the physician said. "It's time to do something."

Harboring a tumor that was now 3.5 centimeters in size, Wayne met with several surgeons near his Illinois home to discuss treatment options. They recommended approaching the tumor through his ear (a translabyrinthine approach), which would result in permanent hearing loss in that ear. Unwilling to accept that result, Wayne began scouring the Internet for other options. "I knew there had to be someone somewhere," he said.

Searching online, he found MayfieldClinic.com and a testimonial from a patient whose acoustic neuroma was similar in size to his. Mayfield surgeons had approached her tumor from an incision in her skull behind her ear (a suboccipital approach) in order to minimize the risk to the adjacent facial and cochlear (hearing) nerves.

Wayne sent his latest MRI scans to Mayfield and about a week later received a call from John M. Tew, MD. "After meeting with him I knew I was in the right place," Wayne says. "I knew I couldn't do any better."

Hope LodgeIn March 2012 Wayne traveled 250 miles to Cincinnati for surgery. At Dr. Tew's recommendation, he stayed about half a mile away from University Hospital at the American Cancer Society's Hope Lodge, where patients and caregivers from out of town can stay at no cost.

"Everything you need is provided there," Wayne said. "I never felt away from home. That was a real plus for me. If anything happened, I was only half a mile from the hospital, so I had no fear, no worries."

A month later, Wayne said his affected ear is doing well. "I have some hearing and I'm able to hear some sounds," Wayne said. "Although the hearing is not that great -- it feels plugged at this time -- I am grateful to have any hearing at all since it was already damaged before I found Mayfield. Dr. Tew was the only surgeon I found who was willing to try to save any of my hearing, so for me any residual hearing is great! I am very pleased with the service I received at Mayfield as well as University Hospital and Hope Lodge."

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Hope Story Disclaimer - "Wayne's Story" is about one patient's health-care experience. Please bear in mind that because every patient is unique, individual patients may respond to treatment in different ways. Results are influenced by many factors and may vary from patient to patient.


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