title: Comparing use of the Sonopet(®) ultrasonic bone aspirator to traditional instrumentation during the endoscopic transsphenoidal approach in pituitary tumor resection.
abstract: BACKGROUND
  The Sonopet(®) ultrasonic bone aspirator (Stryker(®) , Kalamazoo, MI) has been used within neurosurgery, otolaryngology and in other fields, but to our knowledge has not been reported in the literature for use in endoscopic transsphenoidal approaches (TSAs) to the skull base. The study objective was to compare use of the ultrasonic bone aspirator (UBA) vs traditional cold steel instrumentation during TSA in terms of operative time and blood loss.
  
  
  METHODS
  The study design was a prospective, randomized, single-blinded controlled clinical trial. The population included patients who presented to a tertiary care skull base center with pituitary tumors amenable to endoscopic resection. Participants were randomized to either an endoscopic approach using the ultrasonic bone aspirator (n = 66) or traditional steel instrumentation (n = 64). Outcomes measured were operative time and blood loss for the approach and exposure portion of the procedure.
  
  
  RESULTS
  The use of the UBA resulted in a significant reduction in both operative time (31.92 ± 3.04 minutes vs 41.32 ± 2.75 minutes, p < 0.0001) and blood loss (16.5 ± 5.37 milliliters vs 22.57 ± 3.09 milliliters, p < 0.0001) compared to traditional steel instrumentation.
  
  
  CONCLUSIONS
  This study is, to our knowledge, the first prospective, randomized, controlled clinical trial comparatively demonstrating the speed, safety and efficacy of the ultrasonic bone aspirator for endoscopic TSA to the skull base. Although the UBA offers surgical benefits, the cost of disposables may limit its usefulness to use in tertiary care institutions where operative cost can be shared across departments and with the hospital.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: H Michael
authors.initials: HM
authors.lastname: Baddour
authors.forename: Michael D
authors.initials: MD
authors.lastname: Lupa
authors.forename: Zara M
authors.initials: ZM
authors.lastname: Patel
mesh_terms: D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000601:surgery*; D013396:Suction / Q000295:instrumentation; D059708:Ultrasonic Surgical Procedures / Q000295:instrumentation*
keywords: blood loss; operative time; pituitary tumor; transsphenoidal approach; ultrasonic bone aspirator