Piezoelectric bone surgery in otosclerosis

Vercellotti, Tomaso; Dellepiane, Massimo; Mora, Renzo; Salami, Angelo

doi:10.1080/00016480601110154

Cited by 46 publications

(62 citation statements)

References 14 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Methodsmentioning

confidence: 99%

“…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].…”

Section: Methodsmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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Piezosurgery® for removal of symptomatic ear osteoma

Salami

Mora

Dellepiane

et al. 2010

Eur Arch Otorhinolaryngol

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Piezosurgery is an ultrasound instrument (24.7-29.5 kHz) that is able to cut the bone without necrosis and nonmineralized tissue damage. The aim of this work has been to determine the applicability and efficiency of the piezoelectric device in the excision of symptomatic ear osteomas. 10 patients affected by osteoma of the external auditory canal (EAC) (6 right, 4 left) were enrolled. Patients underwent excision of the EAC osteoma through a transcanal approach, with the piezoelectric device. Before and 6 months after surgery, all the patients underwent pure-tone audiometry, tympanometry, transient-evoked otoacoustic emissions, distortion product otoacoustic emissions, auditory brainstem response, and electronystamographic recording. The piezoelectric device provided excellent control without side effects on the adjacent structures of the external, middle and inner ear. The piezoelectric device is a new bony scalpel using the microvibrations at ultrasonic frequency so that soft tissue (nerve, vessel, dura mater, skin, etc.) will not be damaged even on accidental contact with the cutting tip. A feature of the piezoelectric device is its good manageability, which makes it easy for a well-trained otologic surgeon to create a straight osteotomy line: this renders the piezoelectric device suitable for bone surgery and for removal osteomas of the EAC.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…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].…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Piezosurgery® for removal of symptomatic ear osteoma

Salami

Mora

Dellepiane

et al. 2010

Eur Arch Otorhinolaryngol

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“…The microvibrations which are created in the piezoelectric hand-piece cause the inserts to vibrate linearly between 60 and 210 . The amplitude of the ultrasonic waves allows a clean, precise, and selective cut when the insert works on mineralized tissue; yet, it is ineVective on soft tissue (higher frequency waves need to be utilized) [2][3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Piezosurgery® versus microdrill in intact canal wall mastoidectomy

Salami

Mora

Dellepiane

et al. 2010

Eur Arch Otorhinolaryngol

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Piezosurgery is a recently developed system for cutting bone with microvibrations. The objectives of the present study were to report our experience with the piezoelectric device in the intact canal mastoidectomy, and to compare the results with traditional method by means of microdrill. A non-randomized controlled trial was undertaken on 60 intact canal wall mastoidectomy performed using the piezoelectric device (30 patients) or the microdrill (30 patients). Before 1 month and 1 year after surgery, all the patients underwent the following instrumental examinations: otomicroscopic evaluation of the tympanic membrane and external auditory duct, bone conduction threshold audiometry, tympanometry, transient-evoked otoacoustic emissions with linear click emission, distortion product otoacoustic emissions, auditory brainstem response (ABR) by MK 12-ABR screener with natus-ALGO2e (Amplifon, Milan, Italy), and electronystamographic recording. The piezoelectric device is proved to be effective in sclerotic and pneumatic mastoid, with an excellent control and without side effects on the adjacent structures of the middle and inner ear (lateral sinus, facial nerve, and/or dura mater). The operation time has been the same as compared with microdrill, and the average hospital stay was significantly (p < 0.05) shorter. Postoperatively, all patients had uneventful recovery with no evidence of audiovestibular deficit or side effects. Our experience highlights the safety of the piezoelectric device on the anatomic structures of the middle and inner ear, and demonstrates its efficiency in terms of cutting precision and healing process.

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