Piezoelectric ear surgery: asystematic review.

Abstract

The piezoelectric instrument (PEI) offers anovel technique for bone removal in ear surgery with acombination of micro-oscillation and cavitation. The aim of this review is to explore the advantages, disadvantages, and limitations of this instrument in comparison to the drill. We conducted asearch of PubMed/MEDLINE and Google Scholar in accordance with the PRISMA recommendations. The primary selection included all studies reporting on the use of PEI in ear surgery or its effect on the inner ear. Only studies with acontrol group were included in the secondary selection. The first search identified 49studies between 2003 and 2022. These reported on atotal of 1162ear operations, during which PEI was used for various indications. Most data were based on uncontrolled retrospective studies or case reports (76%). Only one of the five controlled clinical studies was prospective and randomized. The advantages of PEI weighed against its limitations and disadvantages were critically analyzed in comparison to the drill. Piezoelectric surgery is an innovative and promising surgical technique in the temporal bone. PEI appears to enable safer and more precise bone removal in close proximity to soft tissue when compared to the drill. The slower bone removal and cost factors represent current limitations to its wider use in ear surgery.