Piezosurgery in otologic surgery: Four years of experience

OBJECTIVES: Piezosurgery (Mectron Medical Technology, Genoa, Italy) is a new ultrasound instrument (24.7-29.5 kHz) that is able to cut the bone without necrosis and nonmineralized tissues damage. The aim of this work has been to report our experience with the piezoelectric device in otologic surgery. STUDY DESIGN: We have used the piezoelectric device in 50 patients affected by otosclerosis, 50 by chronic otitis media, 20 by posttraumatic facial nerve palsy, 10 by type A glomus tympanicum tumor, and in three patients with a B-cell non-Hodgkin lymphoma. SUBJECTS AND METHODS: Patients underwent platinotomy, mastoidectomy, antroatticotomy, posterior tympanotomy, facial nerve decompression, and excision of middle ear tumors. Before and 6 months after surgery, all the patients underwent the following instrumental examinations: pure-tone audiometry, tympanometry, transient-evoked otoacoustic emissions, distortion product otoacoustic emissions, auditory brainstem response, and electronystamographic recording. RESULTS: In each surgical technique, the piezoelectric device provided excellent control without side effects on the adjacent structures of the middle and inner ear. CONCLUSIONS: The piezoelectric device is a new and revolutionary bony scalpel using the microvibrations at ultrasonic frequency so that soft tissue will not be damaged even on accidental contact with the cutting tip; this renders the piezoelectric device ideal for otologic bone surgery.