PERCUTANEOUS BIOPSY OF CAVERNOUS SINUS TUMORS THROUGH THE FORAMEN OVALE

OBJECTIVE: We present a new application to the widely used Hartel perc utaneous route through the foramen ovale to the parasellar region to o btain aspiration biopsies of lesions arising from or invading the post erolateral part of the cavernous sinus. METHODS: Thirteen patients wit h cavernous sinus lesions that were diagnosed using imaging underwent aspiration biopsy by this route. Nine of them were subsequently operat ed on, and two will undergo surgery in the near future. For the remain ing two, surgical removal of the tumor was not indicated. One of these two patients had a meningioma without any related symptoms and no gro wth revealed by repeated computed tomographic scans, and the other was diagnosed as having a nasopharyngeal carcinoma and consequently recei ved radiotherapy. RESULTS: The accuracy of diagnosis with this techniq ue was 84%. There was no complication related to the procedure. Having knowledge of the pathological diagnosis before determining the correc t treatment helped to define the most appropriate strategy. CONCLUSION : We suggest that aspiration biopsy procedures through the foramen ova te be performed in cavernous sinus tumors before making any decision t o indicate open surgical, radiosurgical, and/or radiotherapeutic treat ments.