Ultrasonic surgical aspirator-assisted phonosurgery: A novel technique for laryngeal cartilage dissection

Novel Application of Ultrasonic Bone Aspirator for Hump Nose

OBJECTIVE

This study was conducted to introduce and evaluate the efficacy of an ultrasonic bony aspirator in rhinoplasty for hump removal.

DESIGN

Retrospective study.

SETTING

University medical center.

PATIENTS

Twenty patients who underwent hump removal using an ultrasonic bone aspirator from October 2013 to November 2016 were enrolled in the study.

MAIN OUTCOME MEASURES

Patients were followed for >3 months after surgery. External nose status and surgical results were investigated using photographs. Postoperative complications were evaluated.

RESULTS

Of the 30 patients enrolled in this study, 11 were females and 19 were males. Preoperative nasal deformities of all patients were characterized as bony humps. Postoperative dorsal status was significantly improved. There were no obvious complications such as over or under correction, delayed healing, infection, soft tissue injury, or deformity of the nasal dorsum.

CONCLUSION

Application of an ultrasonic bone aspirator to remove humps in rhinoplasty is easy, safe, and effective.

Piezoelectric technology in otolaryngology, and head and neck surgery: a review

BACKGROUND

Piezoelectric technology has existed for many years as a surgical tool for precise removal of soft tissue and bone. The existing literature regarding its use specifically for otolaryngology, and head and neck surgery was reviewed.

METHODS

The databases Medline, the Cochrane Central Register of Controlled Trials, PubMed, Embase and Cambridge Scientific Abstracts were searched. Studies were selected and reviewed based on relevance.

RESULTS

Sixty studies were identified and examined for evidence of benefits and disadvantages of piezoelectric surgery and its application in otolaryngology. The technique was compared with traditional surgical methods, in terms of intra-operative bleeding, histology, learning curve, operative time and post-operative pain.

CONCLUSION

Piezoelectric technology has been successfully employed, particularly in otology and skull base surgery, where its specific advantages versus traditional drills include a lack of 'blunting' and tissue selectivity. Technical advantages include ease of use, a short learning curve and improved visibility. Its higher cost warrants consideration given that clinically significant improvements in operative time and morbidity have not yet been proven. Further studies may define the evolving role of piezoelectric surgery in otolaryngology, and head and neck surgery.

Osteoradionecrosis of the hyoid bone--a novel application of the Sonopet ultrasonic aspirator

A 66-year-old man with a history of squamous cell carcinoma of the right tonsil presented to the emergency department with two life-threatening episodes of haemoptysis 9 months after completion of chemoradiation. He was evaluated to rule out recurrent malignancy, and was determined to have osteoradionecrosis of his hyoid bone that had led to an oropharyngeal fistula. Given the proximity to branches of the external carotid, he was offered tracheostomy and resection of the protruding necrotic bone with ultrasonic bone aspirator, which was placed down the shaft of the laryngoscope to minimise damage to adjacent structures. He tolerated the procedure well with complete resolution of exposed bone on follow-up laryngoscopy.