Cavernous sinus lesions biopsy with neuronavigation and tip-cut needle

BACKGROUND Transoval biopsy of cavernous sinus (CS) lesions is the last non-invasive diagnostic option in those 15% of patients in whom etiology remains unclear in spite of extensive neuroradiological imaging, clinical assessment, and laboratory evaluation. However, there are no guidelines defining indications and the most appropriate technique for this procedure. CASE DESCRIPTION We present four patients in whom we performed X-ray and neuronavigation-assisted transoval CS biopsies using tip-cut needles. CONCLUSION The technique described allows the operator to determine the optimal angle for entering the CS, avoiding the complications due to distorted anatomy, and facilitating orientation once inside the CS. It reduces both radiation exposure as well as general anesthesia duration.