Percutaneous Biopsy of Parasellar Lesions Through the Foramen Ovale

Parasellar lesions comprise a wide variety of inflammatory and benign or malignant tumorous processes. Each of these lesions requires individual considerations regarding the best management. Percutaneous biopsy through the foramen ovale should be performed in cases of insufficiency of imaging findings to avoid unnecessary open procedures or inappropriate treatment and to guide therapeutic decision. Pathological diagnostic may be sometimes difficult to ascertain with imaging findings. The parasellar region can be reached for biopsy through the foramen ovale percutaneously. After a complete overview of surgical anatomy, the authors describe the used methods. Based on the authors‘ experience with 50 such procedures, the results are described in terms of diagnostic accuracy and morbidity. Percutaneous biopsy revealed a good diagnostic accuracy with a sentitivity of 83% (CI: 52 – 98) and a specificity of 100% (CI: 79 – 100). No mortality was deplored and morbidity was mostly transient. Indications are lesions located in Meckel‘s cave, posterior part of the cavernous sinus and upper part of petroclival region.