Surg Neurol
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Cushing's disease may be treated by surgical pituitary adenomectomy. We present a surgical approach to the pituitary gland that increases the possibilities of a selective adenomectomy, and compare our results with those of other studies. ⋯ Selective adenomectomy with its good opportunities for cure and improvement should be regarded as the treatment of choice for Cushing's disease. Using the lateral rhinotomy approach to the sphenoidal cavity results in good accessibility to the sella turcica and its pituitary adenomas, a low frequency of postoperative pituitary insufficiency, and a high remission rate.
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In spite of advances in noninvasive localization of seizure foci, some cases of intractable limbic epilepsy still require invasive recordings in order to identify the site of seizure onset. This necessitates a safe and reliable method for placing depth and subdural electrodes in the mesial temporal and orbitofrontal regions. The University of Florida has devised a system that utilizes CRW-based stereotactic placement of bitemporal depth electrodes in conjunction with placement of subdural strips over the inferolateral temporal lobe and orbitofrontal cortex. This report describes the surgical technique and initial clinical experience using this method. ⋯ This method provides a safe and effective way to sample bilateral mesial temporal and orbitofrontal regions in cases of intractable limbic epilepsy.