Piezoelectric bone surgery in otosclerosis

Abstract

Conclusion. This test of the Piezosurgery® medical device for osteoplasty of the external auditory duct posterior wall and stapedotomy highlighted the advantages of this device. The device's accuracy and selectivity render it superior to conventionally rotating instruments in otologic surgery. The precise nature of the instrument allows exact, clean, and smooth cut geometries during surgery, without any visible injury to the adjacent soft tissue. Objective. The aim of this work was to test the Piezosurgery® device as a new and alternative method to conventional bone tissue management in otologic surgery and in particular in stapedotomy and the external auditory duct posterior wall. Materials and methods. The Piezosurgery® medical device is a piezoelectric ultrasonic bone-cutting surgical instrument designed to perform sharp cutting actions. The equipment consists of two piezoelectric hand-pieces and two insets that are connected to a main unit, which supplies power and has holders for the hand-piece and irrigation fluids. Piezosurgery uses low frequency ultrasonic waves (24.7–29.5 kHz), the applied power can be modulated between 2.8 and 16 W, and the machine is programmed in accordance with the density of the bone cut. The micro-vibrations that are created in the piezoelectric hand-piece cause the inserts to vibrate linearly between 60 and 210 µm and allow a selective cut of mineralized tissues without trauma to soft tissues. The interoperative irrigation cools down the bone surface and make the operating site blood-free. Twenty patients affected by otosclerosis underwent treatment utilizing the device. Results. In all the patients treated, the characteristics of the ultrasonic frequencies allowed rapid and easy intraoperative management, without any visible injury to the adjacent soft tissue. No side effects were detected.