Piezosurgery in Translabyrinthine-Approach Exposure of the Internal Auditory Canal.

Abstract

To assess the applicability of the piezoelectric device in translabyrinthine-approach exposure of the internal auditory canal. In three cases with vestibular schwannoma, the bone around the internal auditory canal was completely removed by means of piezosurgery. Evaluation was performed by an experienced surgeon, and a second relatively inexperienced surgeon. Irrespective of surgical experience, piezosurgery proved to be a safe method for exposure of the internal auditory canal. Compared with the conventional procedure it provides an improved surgical view and more precise bone removal in a narrow operating field. This novel technique has the characteristics to reduce the corresponding risk of accidental slipping with consequent thermal and mechanical injury to the dura and neurovascular structures. The major disadvantage of piezosurgery is the longer time required for bone removal. The micro-oscillating piezoelectric device is a useful adjunct to the rotating burr during removal of the bone around the internal auditory canal in translabyrinthine approach. It could reduce the risk of injury to neurovascular structures at the bone-to-soft tissue interface.