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Transoral stereotactic technique for clival biopsy
Robert Hirschl1, Brandon Miller, Mario Ammirati
1Department of Neurological Surgery, The Ohio State University Medical Center, Columbus, Ohio.
Summary
A novel transoral freehand technique using continuous image guidance offers a safe and effective method for clival lesion biopsy. This minimally invasive approach simplifies the procedure for obtaining tissue samples from challenging skull base locations.
Area of Science:
- Neurosurgery
- Head and Neck Surgery
- Medical Imaging
Background:
- Clival lesions pose diagnostic challenges due to their anatomical location.
- Biopsy of clival lesions often requires complex surgical approaches.
- Minimally invasive techniques are sought to improve patient outcomes and reduce morbidity.
Observation:
- A transoral freehand technique was employed for biopsy of a clival lesion.
- Continuous image guidance (magnetic resonance and computed tomography) was utilized for navigation.
- A bone biopsy instrument was advanced transorally under image guidance.
Findings:
- Successful placement of bone biopsy instrumentation into the clival lesion.
- Specimen retrieval was achieved using biopsy forceps through the working channel.
- The procedure was well-tolerated, with temporary dysphagia as the main postoperative symptom.
Implications:
- The transoral freehand technique with stereotactic navigation is a simple, safe, and effective method for clival lesion biopsy.
- This approach may offer a less invasive alternative to traditional surgical methods.
- Further research can explore the broader application of this technique in skull base surgery.
