Piezosurgery in the excision of middle ear tumors: effects on mineralized and non mineralized tissues

BACKGROUND: Piezosurgery is a new instrument able to cut bone without necrosis and non-mineralized tissue damage. The aim of this study was to test the Piezosurgery as a new and alternative method for the excision of middle-ear tumors and to analyze its effects on soft tissues. MATERIAL/METHODS: The Piezosurgery device was used to excise eight glomus tympanicum tumors and two primary B-cell lymphomas of the middle ear. The piezoelectric device uses low-frequency ultrasonic waves (24.7-29.5 kHz); the applied power can be modulated between 2.8 and 16 W and is programmed in accordance to the density of the bone. The equipment consists of two hand-pieces, two inserts, and two peristaltic pumps. The microvibrations that are created in the piezoelectric hand-piece cause the inserts to vibrate linearly by between 60 and 210 microm. RESULTS: Piezosurgery provided excellent control in all the patients, without bleeding and harmful effects on the adjacent structures of the middle and inner ear. CONCLUSIONS: Piezosurgery is a new and revolutionary osteotomy technique utilizing the microvibrations of scalpels at ultrasonic frequency, so that soft tissue will not be damaged even upon accidental contact with the cutting tip. The vibration frequency of Piezosurgery is optimal for mineralized tissue and does not cut the adjacent soft tissue, minimizing the risk of harming the adjacent tissues. This renders the piezoelectric device ideal for application at the border between hard and soft tissues as in the excision of a middle-ear tumor.