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Combination of techniques may diagnose cavernous sinus pathology without craniotomy
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LA JOLLA, Calif. — A combination of methods is valuable in diagnosing cavernous sinus pathology, possibly avoiding craniotomy, and ophthalmologists may be suited to make the diagnosis, according to a poster presentation here.
"While imaging studies have revolutionized our ability to make a diagnosis, even the most advanced CT and MRI techniques lack specificity," Steven A. Newman, MD, said in a poster presentation at the American Ophthalmological Society meeting.
The retrospective study included 347 patients who had various neuro-ophthalmic signs and symptoms with evidence of cavernous sinus pathology. They underwent minimally invasive diagnostic techniques, including fine-needle aspiration biopsy, transsphenoidal endoscopic biopsy and translateral orbital extradural procedures.
Sixty percent of patients who underwent trans foramen ovale fine-needle aspiration biopsy successfully obtained a specific diagnosis of cavernous sinus lesions.
If more tissue was needed, transsphenoidal endoscopic biopsy rendered larger specimens, and translateral orbital biopsy resulted in a specific diagnosis without craniotomy in two cases.
"In the presence of neurotropic spread of cancer, distal biopsies permitted specific diagnosis without more invasive techniques," Newman said.
Disclosure: Newman has no relevant financial disclosures.