Magneticresonance imaging (MRI)–negative Cushing disease is one of the most difficult and challenging surgical cases in both pituitary and skull base surgery. Experience is gained by a sequence of success and, unfortunately, failure, which results in a hard-fought experience with these cases. There are a variety of established and novel techniques that would benefit from high-quality video documentation, which could help established surgeons and novices alike improve patient care for this difficult population. In thisNeurosurgical Focus: Videoedition, we present high-quality videos addressing pituitary exploration, cavernous sinus exploration with medial wall removal, and methods of subtotal gland resection. In addition, a video correlating the novel imaging technique of intraoperative ultrasound with a prior MRI–Negative case is presented. Finally, a very interesting series of cases demonstrating suprasellar/infundibular disease is presented. We believe this collection of videos will be a valuable resource for the neurosurgery and endocrine community in these most difficult cases, MRI–Negative Cushing disease.

Disclosures

Dr. Fernandez-Miranda reported personal fees from Stryker, KLS Martin, and Hotry during the conduct of the study.