Monday, March 30, 2009
Faith.Hope.Love
Thursday, March 26, 2009
big words-but some answers.
After being in San Antonio the doctors now know what kind of surgery mom is going to have—it’s a lot of big words but here is the information.
Translabyrinthine Approach
In the translabyrinthine approach, the internal acoustic canal and cerebellopontine angle are approached through a mastoidectomy and labyrinthectomy. There are two goals of bone removal in this approach. The first is to remove enough bone to be able to identify the nerves lateral to the tumor as they course through the internal auditory canal and by the transverse and vertical crests. The second is to expose the dura on the posterior aspect of the temporal bone that faces the cerebellopontine angle. The triangular patch of dura facing the cerebellopontine angle. called Trautmann's triangle, extends from the sigmoid sinus laterally to the superior petrosal sinus above and the jugular bulb below.
In the translabyrinthine exposure, the mastoid cortex is opened and the exposure is directed through the triangular gateway between the facial nerve anteriorly. the sigmoid sinus posteriorly and floor of the middle fossa above. Bone is removed to expose the dura covering the sigmoid sinus and middle fossa, the facial nerve, the angle between the sigmoid sinus and middle fossa dura (called the sinodural angle), and the upper surface of the jugular bulb. The mastoidectomy is carried down to the horizontal semicircular canal, which provides the landmark for identifying the other canals and the facial nerve.
The labyrinthectomy portion of the procedure involves removing the semicircular canals and vestibule to expose the dura lining the internal auditory canal. In the process of removing the semicircular canals, the dura of the middle fossa above the internal acoustic meatus is skeletonized and the dura on the posterior fossa plate behind the canal is exposed. After opening and removing the canals, the vestibule is opened and removed, and the dura lining the posterior half of the internal auditory canal is exposed. Care is required to avoid injury to the facial nerve as it courses below the horizontal canal and the ampulla of the posterior canal and around the superolateral margin of the vestibule. Further bone removal at the lateral end of the canal exposes the transverse and vertical crests and the covering of the superior and inferior vestibular and facial nerves. In removing bone behind the internal acoustic canal, it is important to remember that the jugular bulb may bulge upward behind the posterior semicircular canal or internal auditory meatus. The vestibular aqueduct and endolymphatic sac will be opened and removed as bone is removed between the meatus and the jugular bulb. The cochlear canaliculus will be seen deep to the vestibular aqueduct as bone is removed in the area between the meatus and the jugular bulb. The lower end of the cochlear canaliculus is situated just above the area where the glossopharyngeal nerve enters the medial side of the jugular foramen.
The subarcuate artery or the anterior inferior cerebellar artery may be encountered in the dura of Trautmann's triangle. Commonly, the subarcuate artery, which arises from the anterior inferior cerebellar artery, passes through the dura on the upper posterior wall of the meatus as a fine stem but, on occasion, the subarcuate artery along with its origin from the anterior inferior cerebellar artery may be incorporated into the dura and dip into the subarcuate fossa, on the posterior face of the temporal bone.
They told us the surgery would be this Monday but they have already changed it to April 16th.
Tuesday, March 24, 2009
Thursday, March 19, 2009
madre.
Lynne Anne Farrington Langham
My BEAUTIFUL & wonderful mom was recently diagnosed with acoustic neuroma.
What is an Acoustic Neuroma?
An acoustic neuroma (sometimes termed a vestibular schwannoma or neurolemmoma) is a benign (non-cancerous) growth that arises on the eighth cranial nerve leading from the brain to the inner ear. This nerve has two distinct parts, one part associated with transmitting sound and the other with sending balance information to the brain from the inner ear. The eigth nerve, along with the facial or seventh cranial nerve, lie adjacent to each other as they pass through a bony canal called the internal auditory canal. This canal is approximately 2 cm (0.8 inches) long and it is generally here that acoustic neuromas originate from the sheath surrounding the eighth nerve. The seventh or facial nerve provides motion to the muscles of facial expression.
Tumors range from small to large; mom’s is the largest. She will most likely lose her hearing completely in the left ear – but we are praying that this may not have to be the case. She has a constant ringing in her head everyday, headaches, and some days facial pain. As it says about the tumors are normally benign, technically, doctors can’t be sure of this until they are able to go in for surgery. Our family has been directed to go to a doctor in San Antonio for the surgery, it is the closest best equipped for this type of surgery. The doctors in Amarillo think that having the surgery in San Antonio will be more of a success and requires less risk factors although further away from home, Guymon, Oklahoma. We are constantly praying for perseverance and guidance throughout this whole process. She has an appointment with one of the doctors in San Antonio on the 24th, no new information will come until then. Right now she is HOPEFUL and she shows everyone daily how STRONG she is and how much FAITH she has that the Lord is going to take care of her and our family through this journey.
San Antonio
San Antonio is stress free (maybe not this time) but it’s at least a place to relax- a vacation from Guymon Town!
Mom meets with the team of doctors at 7:30pm on Tuesday.
Keep the prayers flowing.
Acoustic Neuroma Surgery: A Patient's Perspective
by Gary Hunt
Disclaimer: This account is my own and I make no promises as to every medical detail being accurate, the events are as just as I recalled them. Any opinion expressed is entirely my own. I can't promise that each surgery will go exactly like this one, but hope that it offers some insight from a personal perspective. Consult your physician for details.
GO here to read his journal:http://neurosurgery.mgh.harvard.edu/CranialBaseCenter/hunt.htm
Monday, March 16, 2009
Sunday, March 15, 2009
Back to the noog.
Saturday, March 14, 2009
psalm 108 & flowers from a friend
Friday, March 13, 2009
it starts off with a whisper...
Though precise figures have been disputed, Kind of Blue has been cited by many music writers as Miles Davis's best-selling album, as well as the best-selling jazz record of all time.
My family watched an acoustic neuroma surgery today and the surgeon had this lovely album playing in the background.
Made me think of my wonderful friend James Kory “Silky” Wakefield- he means the world to me.
madre.
Lynne Anne Farrington Langham
My BEAUTIFUL & wonderful mom was recently diagnosed with acoustic neuroma.
What is an Acoustic Neuroma?
An acoustic neuroma (sometimes termed a vestibular schwannoma or neurolemmoma) is a benign (non-cancerous) growth that arises on the eighth cranial nerve leading from the brain to the inner ear. This nerve has two distinct parts, one part associated with transmitting sound and the other with sending balance information to the brain from the inner ear. The eigth nerve, along with the facial or seventh cranial nerve, lie adjacent to each other as they pass through a bony canal called the internal auditory canal. This canal is approximately 2 cm (0.8 inches) long and it is generally here that acoustic neuromas originate from the sheath surrounding the eighth nerve. The seventh or facial nerve provides motion to the muscles of facial expression.
Tumors range from small to large; mom’s is the largest. She will most likely lose her hearing completely in the left ear – but we are praying that this may not have to be the case. She has a constant ringing in her head everyday, headaches, and some days facial pain. As it says about the tumors are normally benign, technically, doctors can’t be sure of this until they are able to go in for surgery. Our family has been directed to go to a doctor in San Antonio for the surgery, it is the closest best equipped for this type of surgery. The doctors in Amarillo think that having the surgery in San Antonio will be more of a success and requires less risk factors although further away from home, Guymon, Oklahoma. We are constantly praying for perseverance and guidance throughout this whole process. She has an appointment with one of the doctors in San Antonio on the 24th, no new information will come until then. Right now she is HOPEFUL and she shows everyone daily how STRONG she is and how much FAITH she has that the Lord is going to take care of her and our family through this journey.