Piezosurgery® for removal of symptomatic ear osteoma

Abstract

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.

Piezosurgery in implant dentistry

“… 83 An interdisciplinary use of the piezoelectric device is for orbital surgery 84 – 87 or around the optic nerve canal. 88 The piezoelectric device is also implemented in ear, nose, and throat surgery, 89 – 94 hand surgery, 95 , 96 and thoracic surgery. 97 Another field in which piezosurgery is becoming increasingly attractive and accepted is bone surgery in children.…”

In Vivo Assessment of Bone Healing following Piezotome® Ultrasonic Instrumentation

“…This energy is amplified and transmitted to a surgical tip resulting in linear movement and vibration at frequencies that selectively cut hard tissues. The advantages of piezoelectric surgery in clinical practice have been previously described, and numerous articles have detailed the effectiveness of these units in a variety of dental and medical procedures including lateral window sinus lift techniques, autogenous bone grafting, dental implant site preparation, tooth extractions, periodontal surgery, canal wall mastoidectomy excision of symptomatic ear osteomas, stapedotomy, endoscopic sinus surgery, and head and neck oncological and reconstructive surgery…”

Spongiotic osteoma in the external auditory canal: Two cases of a rare tumor

“…[1][2][3][4][5] Osteoma of the EAC is a rare benign tumor with an estimated incidence of 0.05% of total otologic surgeries. [4][5][6][7] Osteoma is a slow growing mass and usually produces no symptoms. 2,3,6,[8][9][10] However, a mass in the EAC that is suspicious for osteoma should be carefully evaluated, because a large osteoma can cause symptoms.…”

“…[4][5][6][7] Osteoma is a slow growing mass and usually produces no symptoms. 2,3,6,[8][9][10] However, a mass in the EAC that is suspicious for osteoma should be carefully evaluated, because a large osteoma can cause symptoms. Conductive hearing loss and aural fullness can occur when the canal is obstructed.…”