Preoperative Evalution

All patients are seen in consultation with Drs. McMenomey and Delashaw, at which time all records are reviewed, including MRI scans and audiology results. All options are discussed in detail and a plan of treatment is decided upon. If the decision is made to proceed with surgery or radiosurgery, arrangements can be made. This can usually be done at a time which suits the patient. Additional testing may also be ordered. If the decision is made to proceed with surgery, an appointment is also made with the anesthesia preoperative evaluation clinic.

The Operation and Hospital Stay

Patients are generally admitted to the hospital on the day of surgery. The surgery is performed in operating rooms specifically designed for skull base surgery. During the surgery, the nurse in the O.R. is in frequent contact with the family to help alleviate the anxiety that normally exists during this time. At the conclusoin of surgery, the patient will spend one night in the skull base/neurosurgical intensive care unit. This ICU is the most modern intensive care unit in the Northwest. On the first postoperative day, patients are generally transferred out of the intensive care unit. Hospital stays are on average 3-4 days total.

After discharge, it usually takes several weeks before patients feel like returning to work. Therefore, we usually recommend a hiatus from work of at least two weeks. Recovery time varies from patient to patient and is difficult to predict. We see patients in the office about 2 weeks after discharge, and then as needed. There is at least one visit several months after the operation, at which time audiologic examination is performed and results reviewed. All patients are cared for by nursing staff who are members of the skull base surgical team and are thus extremely familiar with this group of patients.

Although risks of complication are low, we pay close attention to this possibility. Some patients may have weakness of the facial muscles postoperatively, which, in almost all, will improve over a period of weeks or months. If this is the case, eye protection is crucial. We may suggest the placement of a small gold weight in the eyelid to allow the eyelid to close easily. As facial strength improves, this weight can easily be removed in the office.