Effects of Piezosurgery® on the cochlear outer hair cells

Abstract

Piezosurgery showed its safety on the inner ear and in particular on the cochlear outer hair cells: for each instrumental examination (pure-tone audiometry, tympanometry, TEOAE, DPOAEs and ABR), no patients presented postoperative worsening.

Piezosurgery® for removal of symptomatic ear osteoma

“…The major surgical challenges of removing obstructive EAC osteoma are related to proximity of the temporomandibular joint, facial nerve injury, inability to visualize the medial EAC landmarks, the thin skin covering the osteoma, and contact with the tympanic membrane [1,2,10]. Table 1 Audiologic results (mean § SD) before (t = 1) and 6 months after (t = 2) the surgical treatment The main advantage of the piezoelectric device is its selective cut that recognizes tissue hardness and works only on mineralized structures without soft-tissue damage [3][4][5][6][7][8]. For these reasons no patient experienced soft-tissue injuries such as tympanic membrane perforation, facial nerve or chorda tympani damage, skin lesion.…”

“…The audiologic results show the safety of the piezoelectric device on the inner ear and in particular on the cochlear outer hair cells and highlight its applicability in the removal of EAC osteoma: the postoperative presence of transient evoked otoacoustic emissions (TEOAE) and distortion product otoacoustic emissions (DPOAE) highlights the absence of an ultrasound eVect such as ampliWcation, damage, etc., on the inner ear and in particular on the cochlear outer hair cells, by the piezoelectric device, whereas the literature reports ultrasound induced damage of vessels with ultrasound at a frequency of 750 kHz [5] (Table 1).…”

“…All the patients were submitted to complete excision of the mass with the piezoelectric device: the equipment consists of two handpieces, two inserts, and two peristaltic pumps connected to the control unit (for cooling during surgery with a jet of physiological solution that discharges from the inserts) [3][4][5][6][7][8]. Handpieces and insert can be sterilized after each use (Fig.…”

“…The microvibrations that are created in the piezoelectric handpiece cause the inserts to vibrate linearly between 60 and 210 m [3][4][5][6][7][8].…”

“…In our department, the piezoelectric device has been used successfully in otologic surgery (stapedotomy, atticoantrotomy, classic intact canal wall mastoidectomy, posterior tympanotomy, facial nerve decompression, and excision of middle ear tumors) [3][4][5][6][7][8]; the characteristics of the piezoelectric bone scalpel seemed so important to us that we wanted to use in the excision of ear canal osteoma.…”