title: Transoral stereotactic technique for clival biopsy.
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.
  
  
  CONCLUSIONS
  The transoral freehand technique with stereotactic navigation was found to be a simple, safe, fast, and effective way to biopsy a clival lesion.
authors.affiliation: Department of Neurological Surgery, The Ohio State University Medical Center, Columbus, Ohio.
authors.forename: Robert
authors.initials: R
authors.lastname: Hirschl
authors.forename: Brandon
authors.initials: B
authors.lastname: Miller
authors.forename: Mario
authors.initials: M
authors.lastname: Ammirati