Piezosurgery in the cochleostomy through multiple middle ear approaches.

OBJECTIVE

Piezosurgery is a new instrument which is able to cut the bone without necrosis and non-mineralized tissues damage. The aim of this work has been to test Piezosurgery as a new and alternative method in cochleostomy.

METHODS

We have performed Piezosurgery on nine temporal bone specimens from voluntary bone donors. Piezosurgery was used in the mastoidectomy with posterior tympanotomy approach (three specimens), suprameatal approach (three specimens) and combined approach (three specimens). The piezoelectric device uses low frequency ultrasonic waves (24.7-29.5 kHz), the applied power can be modulated between 2.8 and 16 W, and is programmed in accordance to the density of the bone. The equipment consists of two handpieces, two inserts and two peristaltic pumps: the microvibrations that are created in the piezoelectric handpiece cause the inserts to vibrate linearly between 60 and 210 microm.

RESULTS

In all the specimens, Piezosurgery provided excellent control without side effects on the adjacent structures of the middle and inner ear.

CONCLUSIONS

Piezosurgery is a new and revolutionary osteotomy technique utilizing the microvibrations of scalpels at ultrasonic frequency, so that soft tissue will not be damaged even upon accidental contact with the cutting tip. The vibration frequency of Piezosurgery is optimal for mineralized tissue and does not cut the adjacent soft tissue, minimizing the risk of harming the adjacent tissues: this renders the piezoelectric device ideal for cochlear implantation in children with ossified, partial ossified cochlea and/or malformation of ear.