Neurosurgery
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To evaluate the feasibility of PoleStar N20 (Medtronic Surgical Navigation Technologies, Louisville, KY), an ultra-low-field intraoperative magnetic resonance imaging (iMRI) system during resection control of pituitary macroadenomas and to compare intraoperative images with postoperative 1.5-T MRI images obtained 3 months after the procedure. ⋯ Ultra-low-field 0.15-T iMRI is a safe, helpful, and feasible tool for navigation and tumor resection control in patients with pituitary macroadenomas. Total anesthesia and operation times are prolonged, but iMRI adequately documents the extent of tumor resection. In this series, the PoleStar system increased the rate of resection without disrupting the neurosurgical workflow.
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To systematically analyze patient outcomes after repeat transsphenoidal (TS) surgery for recurrent Cushing's disease. ⋯ Although the success of repeat TS surgery for recurrence of Cushing's disease is less than that of initial surgery, a second procedure offers a reasonable possibility of immediate remission. If the operation is not successful, other treatments, including pituitary radiation, medical therapy, and even bilateral adrenalectomy, are required.