Sindou M, Chavez J M, Saint Pierre G, Jouvet A
Department of Neurological Surgery, Hôpital Neurologique Pierre Wertheimer, Lyon, France.
Neurosurgery. 1997 Jan;40(1):106-10; discussion 110-1.
We present a new application to the widely used Hartel percutaneous route through the foramen ovale to the parasellar region to obtain aspiration biopsies of lesions arising from or invading the posterolateral part of the cavernous sinus.
Thirteen patients with cavernous sinus lesions that were diagnosed using imaging underwent aspiration biopsy by this route. Nine of them were subsequently operated on, and two will undergo surgery in the near future. For the remaining two, surgical removal of the tumor was not indicated. One of these two patients had a meningioma without any related symptoms and no growth revealed by repeated computed tomographic scans, and the other was diagnosed as having a nasopharyngeal carcinoma and consequently received radiotherapy.
The accuracy of diagnosis with this technique was 84%. There was no complication related to the procedure. Having knowledge of the pathological diagnosis before determining the correct treatment helped to define the most appropriate strategy.
We suggest that aspiration biopsy procedures through the foramen ovale be performed in cavernous sinus tumors before making any decision to indicate open surgical, radiosurgical, and/or radiotherapeutic treatments.
我们提出一种新的应用方法，通过广泛使用的经卵圆孔至鞍旁区域的哈特尔经皮途径，对起源于或侵犯海绵窦后外侧部分的病变进行穿刺活检。
13例经影像学诊断为海绵窦病变的患者通过该途径进行了穿刺活检。其中9例随后接受了手术，2例将在不久的将来接受手术。其余2例，未建议手术切除肿瘤。这2例患者中的1例患有脑膜瘤，无任何相关症状，多次计算机断层扫描显示无生长，另1例被诊断为鼻咽癌，因此接受了放疗。
该技术的诊断准确率为84%。该操作无相关并发症。在确定正确治疗方法之前了解病理诊断有助于确定最合适的策略。
我们建议在决定采用开放手术、放射外科和/或放射治疗之前，对海绵窦肿瘤进行经卵圆孔穿刺活检。
