Image-Guided Biopsies of Superficial and Deep Head and Neck and Skull-Base Lesions

Percutaneous image-guided biopsy has largely replaced open surgical biopsies for many head and neck (H&N) lesions, being very safe and minimally invasive. Although the radiologist plays the primary role in these cases, it requires a multidisciplinary approach. Depending upon numerous factors, these biopsies can be either fine-needle aspiration or core needle biopsy, using ultrasound for superficial lesions and computed tomography for deep neck lesions. The most crucial part of H&N biopsies is planning a trajectory to avoid injury to critical anatomic structures. This article outlines the standard biopsy approaches and key anatomical considerations for H&N procedures.