title: Learning curve for Piezosurgery in well-trained otological surgeons.
abstract: OBJECTIVE
  Piezosurgery is an ultrasound instrument (24.7-29.5 kHz) capable of cutting bone without necrosis and nonmineralized tissue damage. The aim of this work has been to determine the time required for a well-trained surgeon to perform otological surgery with the piezoelectric device.
  
  
  METHODS
  Case series with planned data collection. Sixty-three patients affected by otosclerosis and 63 by chronic otitis media were enrolled. For each disease, patients were divided into three numerically equal groups, with each group assigned to a well-trained otological surgeon. Patients underwent stapedotomy (n = 63) and intact canal wall tympanoplasty (n = 63) with the piezoelectric device.
  
  
  METHODS
  ENT Department, University of Genoa (Italy).
  
  
  METHODS
  We recorded "skin-to-skin" operation time, surgical success, surgical complication, and hospital stay duration. Before and one year after surgery, all patients underwent pure-tone audiometry, tympanometry, recording of transient-evoked otoacoustic emission, recording of distortion product otoacoustic emission, 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 bony scalpel that uses microvibrations at ultrasonic frequency so that soft tissue (nerve, vessel, dura mater, etc) will not be damaged even on accidental contact with the cutting tip. A feature of the piezoelectric device is its good manageability, which makes it easy for a well-trained otological surgeon to create a straight osteotomy line without any learning period: this renders the piezoelectric device suitable for bone surgery.
authors.affiliation: ENT Department, University of Genoa, Genoa, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Salami
authors.forename: Renzo
authors.initials: R
authors.lastname: Mora
authors.forename: Francesco
authors.initials: F
authors.lastname: Mora
authors.forename: Luca
authors.initials: L
authors.lastname: Guastini
authors.forename: Francesco Antonio
authors.initials: FA
authors.lastname: Salzano
authors.forename: Massimo
authors.initials: M
authors.lastname: Dellepiane
mesh_terms: D004867:Equipment Design; D006801:Humans; D010033:Otitis Media / Q000601:surgery*; D010040:Otosclerosis / Q000601:surgery*; D013997:Time Factors; D014464:Ultrasonic Therapy / Q000295:instrumentation