Application of Piezoelectric Device in Endoscopic Sinus Surgery

Abstract

New applications of piezoelectric device have been already documented from otologic and ophthalmic endoscopic studies. The authors describe a first experience in endoscopic sinus surgery with piezosurgery to approach the paranasal sinus. Patients involved in this study presented for rhinogenous headache, rhinorrhea, nasal obstruction, and sinusitis. Radiological studies such as computed tomography of paranasal sinus and a correct clinical examination with a rigid endoscope 0 degrees were carried out, to exclude from the procedure patients with polyposis or other soft-tissue diseases. In fact, because of piezosurgery properties of micrometric and selected cutting on mineralized tissues, it has been used only to treat bone or cartilage anomalies of nasal sinus. The main advantages of the technique include soft-tissue protection and optimal visibility in the surgical field with decreased blood loss. From this preliminary report, the stability of mucous membrane previously cut has been documented by endoscopic follow-up, and the resolution of the main symptom of headache was referred. The main indications for piezosurgery shown in literature are in oral surgery, such as sinus lift, bone graft harvesting, osteogenic distraction, ridge expansion, endodontic surgery, and periodontal surgery. Other applications have been shown in otology, neurosurgery, ophthalmology, and orthopedics. Authors describe as a promising technique the piezoelectric device use in functional endoscopic paranasal sinus surgery in selected cases, with a minimal mucosal approach and thus the preservation of ventilation.

Piezoelectric technology in otolaryngology, and head and neck surgery: a review

“…Cadaveric studies in which the ultrasonic bone aspirator was used to decompress the facial nerve found that operative time halved between the first and second sessions of decompression, providing objective evidence for a short inherent learning curve 26 . This has been anecdotally reported by several other authors, 15 , 37 , 46 , 60 without quantification. Thus, several groups recommend an audited training period for surgeons adopting ultrasonic technology.…”

Morphological Aspect and iNOS and Bax Expression Modification in Bone Tissue Around Dental Implants Positioned Using Piezoelectric Bone Surgery Versus Conventional Drill Technique

“…5 However, this technique is not only clinically effective, as histological and histomorphometric evidences in animal models demonstrated better wound healing and higher bone formation in sites treated through piezoelectric devices with respect to those where conventional bone-cutting techniques, such as diamond or carbide rotary instruments, were used. 7,[10][11][12][13][14][15][16][17][18] In particular, the mid-and long-term success of implant therapy is strictly associated in obtaining primary stability in the early stages and a good osseointegration in the late stages of bone tissue healing around the dental implant. 8,9 In oral and maxillofacial surgery, indications for use of piezoelectric devices are maxillary sinus lift, split-crest, extraction of impacted wisdom teeth, bone biopsy, bone grafts withdrawal, maxillary and mandibular orthognathic surgery, inferior alveolar nerve transposition, in osteoplastic intervention, and, in the last years, also in implant surgery.…”