• Marcos Dellaretti, Almeida Júlio César de JC Department of Neurosurgery, Hospital Santa Casa de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil., Martins Warley Carvalho da Silva WCDS Department of Neurosurgery, Hospital Santa Casa de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil., and Marcello Penholate Faria.
• Department of Neurosurgery, Hospital Santa Casa de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil; Department of Neurosurgery, Rede Mater Dei de Saúde, Belo Horizonte, Minas Gerais, Brazil; Faculty of Medical Sciences of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. Electronic address: mdellaretti@mac.com.
• World Neurosurg. 2017 Dec 1; 108: 1-5.

BackgroundA wide variety of lesions may develop in the cavernous sinus region, including tumors or pseudotumors of inflammatory origin. Sometimes imaging is insufficient to ascertain a pathologic diagnosis. Percutaneous biopsy performed through the foramen ovale route may aid therapeutic decision making, avoiding unnecessary open surgery when lesions are confirmed to be nonsurgical or unresectable. We conducted a systematic review to determine the efficacy of percutaneous biopsy of cavernous sinus lesions.MethodA systematic search in PubMed, LILACS, Web of Science, and Scopus yielded 4495 potentially eligible abstracts. Fourteen studies describing 75 biopsy procedures for lesions in the cavernous sinus region were reviewed. The primary outcome measure was diagnostic success. Data were analyzed according to standard systemic review techniques.ResultsA diagnosis was obtained in 65 of the 75 cases described in the literature. Among all series, only 3 patients had permanent deficits. No individual studies reported mortality. The histopathologic evaluation revealed neoplastic diseases in 58 lesions. Meningiomas were found in 26 biopsy samples. Nonneoplastic diseases, originating from infectious, inflammatory, or deposition diseases, accounted for 6 biopsy samples.ConclusionsPercutaneous biopsy of cavernous sinus lesions is effective for diagnosis. Biopsy can be performed in patients with cavernous sinus masses, especially when neuroimaging fails to provide sufficient histopathologic data.Copyright © 2017 Elsevier Inc. All rights reserved.

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