Transsphenoidal microsurgery for Cushing's disease: initial outcome and long-term results.

Untreated Cushing's disease and the resultant chronically elevated glucocorticoid levels lead to severe metabolic disturbances, including diabetes mellitus, obesity, hypertension, muscle wasting, and osteoporosis. Although transsphenoidal resection has become the standard of care for Cushing's disease with high initial success rates, little information is available on the long-term morbidity and mortality of patients in remission compared with patients with recurrent or persistent Cushing's disease after such treatment. We therefore conducted a retrospective study of 289 patients with Cushing's disease who underwent transsphenoidal microsurgery for an ACTH-secreting adenoma at a tertiary care center exclusively by one surgeon (C.

Predictive model for pain recurrence after posterior fossa surgery for trigeminal neuralgia.

Background: Surgical exploration of the posterior fossa is the definitive treatment for trigeminal neuralgia refractory to medication, but predictors of its success in effecting long-term pain relief have not been established.

Objective: To develop a model that allows stratification of patients' risk of postoperative recurrence of pain based on pretreatment factors.

Methods: We reviewed the records of 420 consecutive patients who underwent posterior fossa exploration by one of us (C.