Lyutenski Stefan, Lieder Anja, Bloching Marc
Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Helios Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Deutschland.
HNO. 2022 Sep;70(9):645-654. doi: 10.1007/s00106-022-01210-9. Epub 2022 Aug 12.
The piezoelectric instrument (PEI) offers a novel technique for bone removal in ear surgery with a combination 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 a search 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 a control group were included in the secondary selection.
The first search identified 49 studies between 2003 and 2022. These reported on a total of 1162 ear 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.
压电器械（PEI）通过微振荡和空化作用相结合，为耳科手术中的骨质去除提供了一种新技术。本综述的目的是探讨该器械相较于钻头的优点、缺点及局限性。
我们按照PRISMA建议在PubMed/MEDLINE和谷歌学术上进行了检索。初步筛选包括所有报道PEI在耳科手术中的应用或其对内耳影响的研究。二次筛选仅纳入有对照组的研究。
首次检索在2003年至2022年间共识别出49项研究。这些研究共报道了1162例耳科手术，期间PEI用于各种适应证。大多数数据基于非对照的回顾性研究或病例报告（76%）。五项对照临床研究中只有一项是前瞻性随机研究。与钻头相比，对PEI的优点及其局限性和缺点进行了批判性分析。
压电手术是颞骨手术中一种创新且有前景的手术技术。与钻头相比，PEI在靠近软组织处似乎能实现更安全、更精确的骨质去除。骨质去除速度较慢和成本因素是其在耳科手术中更广泛应用的当前限制。
