Abstract
Objective
Piezosurgery® is a new instrument which is able to cut the bone without necrosis and non-mineralized tissues damage. The aim of this work has been to report our experience with Piezosurgery® in otologic surgery.
Methods
We have performed Piezosurgery® in platinotomy, mastoidectomy, antroatticotomy, posterior tympanotomy, facial nerve decompression (in its tympanic segment) and excision of middle ear tumours (glomus tympanicum tumour and B-cell non Hodgkin lymphoma). The piezoelectric device uses low frequency ultrasonic waves (24.7–29.5 kHz); the applied power can be modulated between 2.8 and 16W, and is programmed in accordance to the density of the bone. For platinotomy, a specific operative program was created to avoid involuntary error of the power regulation. The equipment consists of two hand-pieces, two inserts, and two peristaltic pumps connected to the control unit; the width, the thickness and the angle of the inserts vary in relation to the power that is applied, the bone density, and the surgical techniques that they are used for.
Results
In each surgical technique, Piezosurgery® provided excellent control without side effects on the adjacent structures of the middle and inner ear.
Conclusions
Piezosurgery® is a new and revolutionary osteotomy technique utilizing the microvibrations of scalpels at ultrasonic frequency, so that soft tissue (nerve, vessel) will not be damaged even upon accidental contact with the cutting tip. The vibration frequency of Piezosurgery® is optimal for mineralized tissue and doesn't cut the adjacent soft tissue, minimizing the risk of harming the adjacent tissues: this renders the piezoelectric device ideal for otologic bone surgery.
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