Learning curve for Piezosurgery in well-trained otological surgeons.
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.
Salami
Angelo
A
ENT Department, University of Genoa, Genoa, Italy.
Mora
Renzo
R
Mora
Francesco
F
Guastini
Luca
L
Salzano
Francesco Antonio
FA
Dellepiane
Massimo
M
D004867:Equipment Design; D006801:Humans; D010033:Otitis Media / Q000601:surgery*; D010040:Otosclerosis / Q000601:surgery*; D013997:Time Factors; D014464:Ultrasonic Therapy / Q000295:instrumentation