Transsphenoidal pituitary surgery is a safe method of treatment in patients with Cushing's disease. Operative findings, radiological and histological findings, together with early postoperative serum cortisol and urine free cortisol estimates may identify failures in treatment. Alternative treatment might then be required for these patients. Because of the risk of late relapse, patients require life-long follow-up.
Our study highlights the finding that over time a significant number of individuals realize a greater ongoing hearing loss in the post tumour excision ear than the contralateral ear.
Clinicians require a reliable and sensitive facial grading system to determine the status of facial nerve function postinjury as well as to evaluate the efficacy of treatment outcomes. The method of assessment should be easy to administer, reproducible, clinically relevant, and require little time and expense. The grading system should be sufficiently sensitive to detect changes over time or following treatment. The lack of a universally accepted grading system frequently does not allow meaningful comparison when assessing the effectiveness of treatment protocols for facial nerve injury. The aim of this article is to review most of the previously published facial grading systems. It is our contention that a grading system developed and currently used within our institution appropriately addresses the needs as well as many of the deficiencies of most other grading systems.
Surgery remains the treatment of choice for mature medial canal fibrosis. With proper surgical technique and meticulous postoperative care, a patent and functioning external ear canal can be achieved in a majority of patients. Absence of recurrence does not equate with improved hearing thresholds.
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