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K-Wire-Assisted Intra-axial Intradural Approach for Cavernous Sinus Biopsy: A Case Report
William K Miller1, Robert P Dunwoody1, Jacqueline N Boyle1
1Neurosurgery, University of Illinois College of Medicine Peoria, Peoria, USA.
Cureus
|December 26, 2024
Summary
This study introduces a novel K-wire-assisted intra-axial intradural biopsy technique for petroclival and cavernous sinus tumors. This approach offers a safe and effective method for obtaining tissue samples in challenging skull base locations.
Area of Science:
- Neurosurgery
- Skull Base Surgery
- Oncology
Background:
- Petroclival and cavernous sinus tumor approaches are complex due to surrounding neurovascular structures.
- Traditional surgical trajectories have limitations in accessing certain lesions.
Observation:
- A 53-year-old female presented with diplopia and headache due to a petroclival and cavernous sinus lesion encasing the internal carotid artery.
- A unique intra-axial, intradural trajectory through the superior temporal gyrus was utilized for biopsy.
- A K-wire was employed to facilitate dural penetration before biopsy needle insertion.
Findings:
- The K-wire-assisted biopsy successfully obtained tissue for diagnosis.
- The patient experienced no postoperative complications.
- Histopathology revealed a grade II chondrosarcoma.
Implications:
- This represents the first reported K-wire-assisted intra-axial intradural biopsy of the lateral cavernous sinus.
- This technique provides a technically straightforward, cost-effective biopsy option for challenging skull base lesions not amenable to resection.
