ABSTRACT
Objective: To report a transoral freehand technique using continuous image guidance
to biopsy a clival lesion. Methods: The patient was placed in a Mayfield head rest.
Patient data were registered using preacquired magnetic resonance and computed tomography
images, and then, under continuous image guidance, a bone biopsy instrument was advanced
freehand through a transoral route into the clival lesion. Results: Bone biopsy instrumentation
was successfully placed into the clival lesion. Biopsy forceps were placed through
the working channel of the biopsy instrumentation and specimen was successfully retrieved
from the clival mass. The patient tolerated the procedure well and the only complaint
was dysphagia, which resolved in several days postoperatively. Conclusion: The transoral
freehand technique with stereotactic navigation was found to be a simple, safe, fast,
and effective way to biopsy a clival lesion.
KEYWORDS
Stereotactic - transoral - clivus - image guidance
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Robert HirschlM.D.
Department of Neurological Surgery, The Ohio State University Medical Center, Columbus,
Ohio N-1021 Doan Hall
410 West Tenth Avenue, Columbus, Ohio 43210
Email: hirschl.1@osu.edu
