title: Potential nerve damage following contact with a piezoelectric device.
abstract: OBJECTIVE
  The aim of the study was to assess the extent of the potential nerve damage following prolonged contact with a piezoelectric device.
  
  
  METHODS
  The study was conducted with 30 patients; all of the patients had cervical metastatic lymph nodes at levels II, III, and IV (N2b) and a negative evaluation for metastatic disease (MO). The patients underwent radical neck dissection. After its skeletonization, the spinal nerve was exposed directly to ultrasonic activation with a piezoelectric device for various times (5, 10, and 20 seconds) and with different inserts (OP3 insert and OT7 insert). The axonal damage was graded from 0 to 3 as follows: 0, no damage; 1, minor axonal damage; 2, severe axonal damage but not covering the entirety of the nerve fascicles; 3, severe axonal damage covering the entirety of the nerve fascicles.
  
  
  RESULTS
  Histologic examination showed no evidence of damage to the perineurium and axons after 5 and 10 seconds of exposure to ultrasonic activation with each insert.
  
  
  CONCLUSIONS
  Our histologic data highlight the selective action of the piezoelectric device, which reduces the risk of accidental nerve damage in otolaryngological bone surgery.
authors.affiliation: Department of Otorhinolaryngology, University of Genoa, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Salami
authors.forename: Renzo
authors.initials: R
authors.lastname: Mora
authors.forename: Barbara
authors.initials: B
authors.lastname: Crippa
authors.forename: Raffaella
authors.initials: R
authors.lastname: Gentile
authors.forename: Massimo
authors.initials: M
authors.lastname: Dellepiane
authors.forename: Luca
authors.initials: L
authors.lastname: Guastini
mesh_terms: D001369:Axons / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D037981:Neck Dissection; D012815:Signal Processing, Computer-Assisted; D012984:Software; D013127:Spinal Nerves / Q000473:pathology*; D013997:Time Factors; D014465:Ultrasonics / Q000295:instrumentation*