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Marchioni D, Ronzani G, Gazzini S, Fulco G, Rubini A. The Impact of Piezoelectric Device in Cholesteatoma Endoscopic Surgery: Retrospective Evaluation of Safety and Functional Results. Otol Neurotol 2024; 45:e420-e426. [PMID: 38728558 DOI: 10.1097/mao.0000000000004181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
OBJECTIVE Atticotomy represents an essential surgical step within the management of attical cholesteatoma during endoscopic ear surgery. The aim of the present study was to evaluate the safety and functional results of an endoscopic atticotomy performed with piezosurgery, in terms of audiological outcomes and tissue's healing. METHODS This is an observational retrospective study on patients with attical cholesteatoma who underwent endoscopic ear surgery with piezoelectric atticotomy and subsequent scutum reconstruction either with tragal cartilage or temporalis muscle fascia. Scutumplasty's status was evaluated via scheduled outpatient controls through an endoscopic check and classified as stable or unstable at least 10 months after surgery. A pre- and postoperative audiometric examination was performed in each patient. RESULTS Eighty-four patients were enrolled. In 50 out of 84 patients (59.52%), an exclusive endoscopic procedure was performed, whereas in 34 patients (40.48%) a combined microscopic/endoscopicapproach was adopted. In 72 cases (85.71%), scutum's reconstruction appeared to be normally positioned, whereas 12 patients developed a retraction pocket, which was self-cleaning in 8 of them and non-self-cleaning in the remaining 4. In 17 patients, a slight sensorineural hearing loss (between 5 and 15 dBHL) was observed, and in 2 patients, the loss was greater than 15 dBHL. Overall, no significative differences between pre- and postoperative pure-tone average bone thresholds resulted (p = 0.4983), though a mild significant hearing deterioration was detected by the specific analysis at 4000 Hz (p = 0.0291). CONCLUSION Piezosurgery represents an extremely useful tool in performing atticotomy during endoscopic tympanoplasties. Our data seem to support the safety of its usage in this specific step, as it did not lead to any significant sensorineural damage on overall pure-tone average. Moreover, satisfactory tissue healing in regard to scutum reconstruction was observed.
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Affiliation(s)
- Daniele Marchioni
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Modena, Modena, Italy
| | - Guglielmo Ronzani
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Verona, Verona, Italy
| | - Sandra Gazzini
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Verona, Verona, Italy
| | - Gianfranco Fulco
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Verona, Verona, Italy
| | - Alessia Rubini
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Modena, Modena, Italy
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Lyutenski S, Lieder A, Bloching M. Piezoelectric ear surgery: a systematic review. HNO 2023; 71:10-18. [PMID: 36205754 DOI: 10.1007/s00106-022-01211-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The piezoelectric instrument (PEI) offers a novel technique for bone removal in ear surgery with a combination of micro-oscillation and cavitation. The aim of this review is to explore the advantages, disadvantages, and limitations of this instrument in comparison to the drill. MATERIALS AND METHODS We conducted a search of PubMed/MEDLINE and Google Scholar in accordance with the PRISMA recommendations. The primary selection included all studies reporting on the use of PEI in ear surgery or its effect on the inner ear. Only studies with a control group were included in the secondary selection. RESULTS The first search identified 49 studies between 2003 and 2022. These reported on a total of 1162 ear operations, during which PEI was used for various indications. Most data were based on uncontrolled retrospective studies or case reports (76%). Only one of the five controlled clinical studies was prospective and randomized. The advantages of PEI weighed against its limitations and disadvantages were critically analyzed in comparison to the drill. CONCLUSION Piezoelectric surgery is an innovative and promising surgical technique in the temporal bone. PEI appears to enable safer and more precise bone removal in close proximity to soft tissue when compared to the drill. The slower bone removal and cost factors represent current limitations to its wider use in ear surgery.
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Affiliation(s)
- Stefan Lyutenski
- Department of Otorhinolaryngology, Helios Hospital Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany.
| | - Anja Lieder
- Department of Otorhinolaryngology, Helios Hospital Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany
| | - Marc Bloching
- Department of Otorhinolaryngology, Helios Hospital Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany
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Kisel J, Khatib M, Cavale N. A Comparison Between Piezosurgery and Conventional Osteotomies in Rhinoplasty on Post-Operative Oedema and Ecchymosis: A Systematic Review. Aesthetic Plast Surg 2023; 47:1144-1154. [PMID: 36163553 PMCID: PMC10229687 DOI: 10.1007/s00266-022-03100-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/05/2022] [Indexed: 12/01/2022]
Abstract
Piezosurgery use has become increasingly prevalent in osteotomies. Piezoelectric ultrasound waves can cut bone effectively, and some studies have shown reduced post-operative morbidities compared to conventional osteotomies. Oedema and ecchymosis are common complications of rhinoplasty and can impact patient satisfaction, wound healing, and recovery. We aim to provide an up-to-date comparison of post-operative oedema and ecchymosis in piezosurgery and conventional osteotomies. A literature search was conducted using the following online libraries; Pubmed, Cochrane, Science Direct, and ISRCTN (International Standard Randomised Controlled Trial Number). English publications between 2015 and 2020 were included. A systematic review was completed, and a comparison of oedema and ecchymosis in piezosurgery and conventional osteotomies was examined alongside other outcomes such as pain, mucosal injury, and surgery time. Eight randomised controlled trials (RCTs) met our criteria with a combined total of 440 patients: 191 male and 249 female. Piezosurgery had statistically significant (p < 0.05) reduction in short-term oedema compared to conventional osteotomies in 75% of the papers included, and in 50% this persisted across the whole follow-up period. Similarly, ecchymosis scoring was initially statistically lower (p < 0.05) in piezosurgery in 87.5% of the RCTs, and in 75% this persisted across the whole follow-up period. A reduction in pain (p < 0.05) and mucosal injury (p < 0.05) was also seen in piezoelectric osteotomies. The length of surgery time varied. Piezoelectric osteotomies reduce oedema and ecchymosis compared to conventional osteotomies, in addition to improving pain and mucosal injury. However, disadvantages such as length of surgery time and cost have been reported. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Janneta Kisel
- Faculty of Life Sciences and Medicine, King's College London, Guy's Campus, Great Maze Pond, London, SE1 1UL, UK.
| | - Manaf Khatib
- Faculty of Life Sciences and Medicine, King's College London, Guy's Campus, Great Maze Pond, London, SE1 1UL, UK
- Lister Hospital, East and North Hertfordshire NHS Trust, Stevenage, UK
| | - Naveen Cavale
- Faculty of Life Sciences and Medicine, King's College London, Guy's Campus, Great Maze Pond, London, SE1 1UL, UK
- King's College Hospital and Guy's & St.Thomas' Hospitals, King's College Hospital and Guy's & St.Thomas' Hospitals NHS Trusts, London, UK
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Orabona GD, Abbate V, Maffia F, Romano A, Bonavolontà P, Valletta A, Iaconetta G, Califano L. Piezoelectric Condylectomy Through Transoral Endoscopic Approach: A Cadaveric Study. Indian J Otolaryngol Head Neck Surg 2023; 75:963-966. [PMID: 37275105 PMCID: PMC10235273 DOI: 10.1007/s12070-022-03168-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/09/2022] [Indexed: 11/08/2022] Open
Abstract
Surgical approaches in the treatment of TMJ pathologies are a much-debated topic in literature. We propose a new surgical approach performed by intraoral access and completed by endoscopic magnification and long-tip piezosurgery assistance. A piezosurgery (Piezosurgery Plus, Mectron s.p.a. 2014) with a long angled tip (MT5-10 L) was used to perform an endoscopically assisted condylectomy. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-022-03168-0.
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Affiliation(s)
- Giovanni Dell’Aversana Orabona
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
| | - Vincenzo Abbate
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
| | - Francesco Maffia
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
| | - Antonio Romano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
| | - Paola Bonavolontà
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
| | - Alessandra Valletta
- Dentistry Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
| | - Giorgio Iaconetta
- Neurosurgery Unit Department of Medicine, Surgery and Odontoiatrics, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano Salerno, Italy
| | - Luigi Califano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
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Khajuria A, Krzak AM, Reddy RK, Lai K, Wignakumar T, Rohrich RJ. Piezoelectric Osteotomy versus Conventional Osteotomy in Rhinoplasty: A Systematic Review and Meta-analysis. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2022; 10:e4673. [PMID: 36448013 PMCID: PMC9699654 DOI: 10.1097/gox.0000000000004673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 09/27/2022] [Indexed: 11/24/2022]
Abstract
Previous systematic reviews evaluating piezoelectric osteotomy are of critically low quality. We conducted a high-quality systematic review and meta-analysis to evaluate outcomes for piezoelectric versus conventional osteotomy. Methods The study protocol was published a priori (PROSPERO: CRD42021287877). MEDLINE, Embase, Web of Science, and CENTRAL were searched for studies comparing piezoelectric versus conventional osteotomes and reporting at least one outcome of interest (clinical or patient-reported outcomes, PROs). Methodological quality and risk of bias were assessed using GRADE and Cochrane's RoB-2/ROBINS-I tools, respectively. Random effects models were applied. Results Of 347 articles, 10 studies (nine randomized controlled trials; one prospective cohort study) including 554 patients were included. Piezoelectric osteotomy was associated with significantly reduced edema [standardized mean difference (SMD), -0.67; 95% confidence interval (CI), -1.03 to -0.30; P < 0.0004], ecchymosis (SMD, -0.93; 95% CI, -1.13 to -0.73; P < 0.00001), and pain (SMD, -1.48; 95% CI, -2.07 to -0.88; P < 0.00001) compared with standard osteotomy. Odds of mucosal injury were significantly lower following piezoelectric osteotomy (odds ratio, 0.06; 95% CI, 0.01 to 0.52; P = 0.01). There was no difference in duration of osteotomy (SMD, 3.15; 95% CI, -1.82 to 8.12; P = 0.22) or total procedure duration (SMD, 0.46; 95% CI, -0.43 to 1.36; P = 0.31). One study reported PROs, favoring piezoelectric osteotomy. Conclusion This systematic review and meta-analysis provides support (albeit weak, due to low-quality evidence) for piezoelectric over conventional osteotomy, for reducing morbidity in the early postoperative period. High-quality level I data reporting PROs will optimize shared decision-making/informed consent.
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Affiliation(s)
- Ankur Khajuria
- From the Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- Kellogg College, University of Oxford, Oxford, United Kingdom
| | - Ada M. Krzak
- Cambridge University Hospitals, Cambridge, United Kingdom
| | - Rohin K Reddy
- Kellogg College, University of Oxford, Oxford, United Kingdom
| | - Kenneth Lai
- Department of Otolaryngology, Maidstone and Tunbridge Wells NHS Trust, Oxford, United Kingdom
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Karchynskyi OO, Karchynska TO, Lupyr AV. ASSESSMENT OF THE EFFICIENCY OF PIEZOELECTRIC AND CLASSIC OSTEOTOMY WHEN PERFORMING SEPTORHINOPLASTY. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:2594-2597. [PMID: 36591738 DOI: 10.36740/wlek202211107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The aim: Comparison and analysis of the main intraoperative and postoperative results of piezoelectric and traditional osteotomy in septorhinoplasty. PATIENTS AND METHODS Materials and methods: Examination and treatment were carried out in 40 patients who were divided into two groups. The first included patients who underwent septorhinoplasty using a traditional osteotomy - 20 people (control group). In the second group of patients, piezoelectric surgery was used for septorhinoplasty. This research group consisted of 20 people. All patients of both groups underwent only primary septorhinoplasty by closed and open methods. Piezoelectric surgery was performed using a Japanese VarioSurg3 NSK piezotome. RESULTS Results: The research was conducted on the first day after surgery, 3 days and a week after treatment. The following indicators were evaluated: intraoperative complications (mucosa damage), postoperative complications: (swelling of the eyelids,periorbital ecchymoses, nasal secretion activity, inflammatory reaction of the nasal cavity, postoperative pain). Significantly fewer cases of mucosal damage were detected in the second study group compared to the first. And the severity of postoperative complications in the second group of patients who underwent septorhinoplasty with the help of a piezotome was statistically significantly (p<0.05) lower than in patients of the control group. CONCLUSION Conclusions: Piezoelectric surgery has a number of advantages over traditional osteotomy techniques, such as selectivity of impact on soft tissues, accuracy of bone destruction. Piezoelectric osteotomy during septorhinoplasty can reduce intra- and postoperative complications with statistical reliability.
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7
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Powered Micro-saw Versus Conventional Osteotome for Septorhinoplasty: A Prospective, Double-Blind, Comparative Study. Aesthetic Plast Surg 2022; 47:1133-1141. [DOI: 10.1007/s00266-022-03083-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 08/21/2022] [Indexed: 01/13/2023]
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8
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Lyutenski S, Lieder A, Bloching M. [Piezoelectric ear surgery: a systematic review. German version]. HNO 2022; 70:645-654. [PMID: 35960310 DOI: 10.1007/s00106-022-01210-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND The piezoelectric instrument (PEI) offers a novel technique for bone removal in ear surgery with a combination of micro-oscillation and cavitation. The aim of this review is to explore the advantages, disadvantages, and limitations of this instrument in comparison to the drill. MATERIALS AND METHODS We conducted a search of PubMed/MEDLINE and Google Scholar in accordance with the PRISMA recommendations. The primary selection included all studies reporting on the use of PEI in ear surgery or its effect on the inner ear. Only studies with a control group were included in the secondary selection. RESULTS The first search identified 49 studies between 2003 and 2022. These reported on a total of 1162 ear operations, during which PEI was used for various indications. Most data were based on uncontrolled retrospective studies or case reports (76%). Only one of the five controlled clinical studies was prospective and randomized. The advantages of PEI weighed against its limitations and disadvantages were critically analyzed in comparison to the drill. CONCLUSION Piezoelectric surgery is an innovative and promising surgical technique in the temporal bone. PEI appears to enable safer and more precise bone removal in close proximity to soft tissue when compared to the drill. The slower bone removal and cost factors represent current limitations to its wider use in ear surgery.
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Affiliation(s)
- Stefan Lyutenski
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Helios Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Deutschland.
| | - Anja Lieder
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Helios Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Deutschland
| | - Marc Bloching
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Helios Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Deutschland
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9
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Taylor A, North H, Singh NP, Fagan PA. From wipeout to drill out: a history of exostosis management and Australian surfing. Med J Aust 2022; 216:401-404. [DOI: 10.5694/mja2.51496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Hannah North
- Westmead Clinical School University of Sydney Sydney NSW
| | - Narinder P Singh
- Westmead Hospital Sydney NSW
- Westmead Clinical School University of Sydney Sydney NSW
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Piezosurgery: Application in endoscopic otorhinolaryngology. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2022.100302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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11
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Krishnapura SG, Gallant JN, Lin C, Ceremsak J, Topf MC. Saccular Cyst Resection via a Lateral Thyrotomy Approach-A Novel Application of the Ultrasonic Bone Aspirator. EAR, NOSE & THROAT JOURNAL 2022:1455613221091103. [PMID: 35379017 DOI: 10.1177/01455613221091103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Jean-Nicolas Gallant
- Department of Otolaryngology-Head and Neck Surgery, 12328Vanderbilt University Medical Center, Nashville, TN, USA
| | - Chen Lin
- Department of Otolaryngology-Head and Neck Surgery, 12328Vanderbilt University Medical Center, Nashville, TN, USA
| | - John Ceremsak
- Department of Otolaryngology-Head and Neck Surgery, 12328Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michael C Topf
- Department of Otolaryngology-Head and Neck Surgery, 12328Vanderbilt University Medical Center, Nashville, TN, USA
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McGuire C, Boudreau C, Prabhu N, Hong P, Bezuhly M. Piezosurgery versus Conventional Cutting Techniques in Craniofacial Surgery: A Systematic Review and Meta-Analysis. Plast Reconstr Surg 2022; 149:183-195. [PMID: 34936620 DOI: 10.1097/prs.0000000000008645] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Despite its increasing use in craniofacial surgery, the evidence for piezosurgery over conventional bone-cutting techniques has not been critically appraised. The purpose of this systematic review and meta-analysis was to identify and assess the evidence that exists for the use of piezosurgery in craniofacial surgery. METHODS A systematic review was undertaken using a computerized search. Publication descriptors, methodologic details, and outcomes were extracted. Articles were assessed using the methodologic index for nonrandomized studies and Cochrane instruments. Random effects meta-analysis was completed. RESULTS Thirty-nine studies were included. Most studies were published within the past 5 years (51.3 percent) and were randomized controlled trials (56.4 percent). The mean age of patients was 27 years (range, 0.2 to 57 years), and the mean sample size was 44 (range, 12 to 180). Meta-analysis revealed that compared to conventional instruments, piezosurgery had a lower postoperative incidence of sensory disturbance, principally in mandibular procedures (OR, 0.29; 95 percent CI, 0.11 to 0.77; p = 0.01) and pain at postoperative day 3 (mean difference, -0.86; 95 percent CI, -1.20 to -0.53; p < 0.01). There was no statistically significant difference in operating room time (mean difference, 8.60; 95 percent CI, -1.27 to 18.47; p = 0.80) or osteotomy time (mean difference, 0.35; 95 percent CI, -2.99 to 3.68; p = 0.84). Most studies were clinically homogenous (92 percent) and of high quality based on the methodologic index for nonrandomized studies instrument (84 percent). Few studies had domains at high risk of bias based on the Cochrane instrument (28.6 percent). CONCLUSIONS Piezosurgery has considerable benefits when compared to conventional instruments. Future studies should investigate its cost-effectiveness and benefits in terms of blood loss, edema/ecchymosis, and patient satisfaction.
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Affiliation(s)
- Connor McGuire
- From the Division of Plastic Surgery, the Faculty of Medicine, and Division of Otolaryngology, Dalhousie University
| | - Colton Boudreau
- From the Division of Plastic Surgery, the Faculty of Medicine, and Division of Otolaryngology, Dalhousie University
| | - Neetin Prabhu
- From the Division of Plastic Surgery, the Faculty of Medicine, and Division of Otolaryngology, Dalhousie University
| | - Paul Hong
- From the Division of Plastic Surgery, the Faculty of Medicine, and Division of Otolaryngology, Dalhousie University
| | - Michael Bezuhly
- From the Division of Plastic Surgery, the Faculty of Medicine, and Division of Otolaryngology, Dalhousie University
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Piezoelectric canalplasty for exostoses and osteoma. Am J Otolaryngol 2021; 42:103114. [PMID: 34166964 DOI: 10.1016/j.amjoto.2021.103114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 06/13/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate the safety profile and surgical technique for removal of symptomatic exostoses and osteoma of the external auditory canal with a micro-oscillating piezoelectric device. METHOD A chart review was conducted on patients undergoing piezoelectric canalplasty between 2019 and 2021 at tertiary referral hospital. Surgery was performed by two surgeons with varying experience. Bone removal was achieved using both osteotomy and osteoplasty. Postoperative complications, operative time and hearing outcome were evaluated. RESULTS The study comprised 16 patients (16 ears). No major complications occurred. The skin of the auditory canal was completely preserved in all patients without injury to the tympanic membrane. Except for one patient with known noise-induced hearing loss, there was no postoperative deterioration of the bone-conduction threshold more than 10 dB HL at any frequency. The difference of the bone-conduction threshold in pure-tone audiometry (average for 0.5, 1, 2 and 4 kHz) three weeks postoperatively had a median of 0.6 dB ± 5.7. One patient complained of temporary new tinnitus. One patient had prolonged wound healing. Mean operative time was comparable with literature data. CONCLUSION The atraumatic characteristics of the piezoelectric instrument enable low-risk removal of external auditory canal exostoses and osteoma. Through the combination of precise osteotomy and osteoplasty, this novel instrument has the potential to become established in routine canalplasty.
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Varela-Centelles P, Seoane J, Ulloa-Morales Y, Estany-Gestal A, Blanco-Hortas A, -García-Pola MJ, -Seoane-Romero JM. Oral cancer awareness in North-Western Spain: a population-based study. Med Oral Patol Oral Cir Bucal 2021; 26:e518-e525. [PMID: 34162825 PMCID: PMC8254879 DOI: 10.4317/medoral.24401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 02/15/2021] [Indexed: 01/14/2023] Open
Abstract
Background An early diagnosis depends greatly on patient awareness. Thus, the aim of this study was to investigate general awareness of oral cancer and knowledge about its risk factors, signs and symptoms.
Material and Methods Cross-sectional population-based survey of randomly selected respondents conducted from March 1, 2015 to 30 June 2016.
Results A total of 5,727 people entered the survey (response rate: 53%). When asked what cancers participants had heard about, 20.3% mentioned oral cancer. Regarding risk factors, tobacco was mentioned by 55.3% of the sample (n=3,169), followed by alcohol (12.5%; n=708), poor oral hygiene (10.8%; n=618), diet (6.5%; n=377), and genetics (4.5%; n=248).
Conclusions General population has low awareness of oral cancer with poor knowledge of risk factors and main alarm signs. In addition, individuals in the risk group scored lower values in the main variables analysed; even those highly educated showed insufficient awareness and knowledge of oral cancer. In these circumstances, there is clear need for educational interventions tailored to the target audience and aimed at increasing knowledge and awareness of oral cancer to promote primary prevention of oral cancer and minimising the time interval of patients with symptomatic oral cancer in their path to treatment. Key words:Oral cancer, awareness, risk factors, surveys and questionnaires, Spain.
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Marchioni D, Laura E, Rubini A. Decompression of the geniculate ganglion and labyrinthine segments of the facial nerve through a middle cranial fossa approach using an ultrasonic surgical system: an anatomic study. Eur Arch Otorhinolaryngol 2021; 279:2777-2782. [PMID: 34191113 DOI: 10.1007/s00405-021-06966-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 06/25/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study is to evaluate the feasibility and the safety of a novel, alternative method for bone tissue management in facial nerve decompression by a middle cranial fossa approach. Several applications of Piezosurgery technology have been described, and the technique has recently been extended to otologic surgery. The piezoelectric device is a bone dissector which, using micro-vibration, preserves the anatomic integrity of soft tissue thanks to a selective action on mineralized tissue. METHODS An anatomic dissection study was conducted on fresh-frozen adult cadaveric heads. Facial nerve decompression was performed by a middle cranial fossa approach in all specimens using the piezoelectric device under a surgical 3D exoscope visualization. After the procedures, the temporal bones were examined for evidence of any injury to the facial nerve or the cochleovestibular organs. RESULTS In all cases, it was possible to perform a safe dissection of the greater petrosal superficial nerve, the geniculate ganglion, and the labyrinthine tract of the facial nerve. No cases of semicircular canal, cochlea, or nerve damage were observed. All of the dissections were carried out with the ultrasonic device without the necessity to replace it with an otological drill. CONCLUSION From this preliminary study, surgical decompression of the facial nerve via the middle cranial fossa approach using Piezosurgery seems to be a safe and feasible procedure. Further cadaveric training is recommended before intraoperative use, and a wider case series is required to make a comparison with conventional devices.
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Affiliation(s)
- Daniele Marchioni
- Department of Otolaryngology Head and Neck Surgery Department, University of Verona, Piazzale Aristide Stefani, 1, 37126, Verona, Italy
| | - Elisa Laura
- Department of Otolaryngology Head and Neck Surgery Department, University of Verona, Piazzale Aristide Stefani, 1, 37126, Verona, Italy.
| | - Alessia Rubini
- Department of Otolaryngology Head and Neck Surgery Department, University of Verona, Piazzale Aristide Stefani, 1, 37126, Verona, Italy
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Gulnahar Y, Alpan AL. Comparison of postoperative morbidity between piezoelectric surgery and conventional rotary instruments in mandibular third molar surgery: a split-mouth clinical study. Med Oral Patol Oral Cir Bucal 2021; 26:e269-e275. [PMID: 33772570 PMCID: PMC8141306 DOI: 10.4317/medoral.24085] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 02/01/2021] [Indexed: 01/05/2023] Open
Abstract
Background The extraction of impacted third molar teeth is a common procedure in maxillofacial surgery. The aim of this study was to compare of piezoelectric surgical technique with the one with conventional rotary instruments in terms of edema, trismus and pain, in mandibular third molar surgery.
Material and Methods 20 individuals with symmetrically impacted lower mandibular third molars and 40 teeth were included in the study. Third molars on the left side of each patient were removed with piezosurgery, while the counterparts on the right side were removed with conventional rotary instruments. Postoperatively, the same antibiotic, analgesic, and mouthwash were recommended to both groups. Ultrasound, edema, trismus measurements were performed before surgery, postoperative, postoperative day 2 and postoperative day 7. VAS scale was used to evaluate the pain.
Results The average age of 20 individuals included in the study was found to be 21.85 ± 3.08 years. The operation time of the individuals who underwent the surgery with conventional rotary instruments was found to be 12 minutes 31.70 ± 167.03 seconds, and the operation time in the Piezosurgery group was 19 minutes 10.60 ± 306.59 seconds. There was no significant difference between the two groups in terms of trismus, edema, and pain.
Conclusions Piezosurgery is a safe method that can be used in molar removal, but in this split-mouth study, it is not found advantageous in terms of postoperative morbidity due to the longer working time compared to the one performed with conventional rotary instruments. Key words:Edema, impacted third molar, pain, piezosurgery, trismus.
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Affiliation(s)
- Y Gulnahar
- Pamukkale University Faculty of Dentistry Department of Periodontology Kınıklı Campus 20160 Denizli, Turkey
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Abstract
ABSTRACT Achieving aesthetic and functional results in rhinoplasty requires meticulous techniques, and postoperative edema, ecchymosis, and pain can deteriorate the desired outcomes. Different osteotomy techniques are defined to have optimal outcomes while reducing edema, ecchymosis, and pain. In this study, the authors compared conventional and power-assisted surgical burr osteotomy techniques in terms of early postoperative complications. Patients who underwent primary open septorhinoplasty were included in the study and were divided into 2 groups. The first group had lateral endonasal osteotomy with conventional guided osteotomes, and the second group had lateral osteotomy with surgical round burr. Edema and ecchymosis scoring systems were used on the postoperative first, third, and seventh day to evaluate postoperative edema and ecchymosis, and the visual analog scale was used to evaluate pain severity on the postoperative period. Out of 70 patients who had undergone septorhinoplasty, 36 received conventional osteotomy and 34 received surgical round burr osteotomy. Periorbital ecchymosis scores were significantly lower in the second group on the postoperative first, third, and seventh days. The periorbital edema scores were significantly lower in the second group on the first postoperative day but no difference was found between postoperative days 3 and 7. Also, the pain scores were significantly lower in the second group. Osteotomy with surgical round burr yields less ecchymosis, edema, and pain in the early postoperative period than conventional osteotomy in primary septorhinoplasty patients.
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Schlabe J, Echlin K, Atherton D. A comparison of piezo surgery osteotomies with conventional internal osteotomies as performed by trainee surgeons: a cadaveric study. Ann R Coll Surg Engl 2021; 103:272-277. [PMID: 33682473 DOI: 10.1308/rcsann.2020.7120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Aesthetic rhinoplasty remains a challenging procedure with high expectations and narrow tolerance for errors. Considerable training is required to achieve controlled and reliable results. Use of the Piezotome is gaining popularity for performing the nasal osteotomies, a key step in rhinoplasty, where it is reported to improve precision and predictability and to keep tissue damage to a minimum. We compare the outcomes of conventional osteotomy techniques to piezosurgery in human cadavers as undertaken by surgical trainees. MATERIALS AND METHODS Seven human cadavers were used and a total of 14 osteotomies were performed. Conventional osteotomies and piezosurgery were carried out each on one side of the cadaver. A number of fragments and a blinded assessment of the accuracy of the osteotomy compared with the preprocedure skin markings were carried out by two experienced rhinoplasty surgeons. The Mann-Whitney test for statistical analysis was used. RESULTS The mean number of fragments was 1.57 in the piezosurgery osteotomy and 2.14 using conventional osteotomies. Four of seven piezosurgery osteotomies achieved an accuracy within 1mm. The conventional osteotomies as performed by the trainees showed a significant mismatch of more than 3mm in three of seven of cases. Accuracy within 1mm was achieved in one of seven cases. DISCUSSION Piezosurgery offers a safe, reliable and precise method of performing lateral nasal osteotomies. This human cadaver study shows a high accuracy of osteotomy and fewer comminuted fractures using this technique compared with conventional osteotomy techniques.
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Affiliation(s)
- J Schlabe
- Guy's and St Thomas' Hospital, London, UK
| | - K Echlin
- Birmingham Children's Hospital, Birmingham, UK
| | - D Atherton
- Guy's and St Thomas' Hospital, London, UK
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Morrison DR, Moore LS, Walsh EM. Perioperative Pain Management Following Otologic Surgery. Otolaryngol Clin North Am 2020; 53:803-810. [PMID: 32682533 DOI: 10.1016/j.otc.2020.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Otologic surgery involves a broad range of procedures. In general, postoperative pain from most otologic surgeries can be managed with little to no opioids, and surgeons should make a concerted effort to minimize narcotic prescriptions in the midst of the opioid crisis. Many procedures, including transcanal surgeries and even postauricular surgeries, may performed with local anesthetic in selected patients. Multimodal pain regimens, local anesthesia, and alternative approaches have shown promise in minimizing narcotic use, and should be considered. Preoperative counseling to appropriately manage expectations and goals is imperative for patient satisfaction and safety.
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Affiliation(s)
- Daniel R Morrison
- Department of Otolaryngology, University of Alabama at Birmingham, Faculty Office Tower 1155, 1720 2nd Avenue South, Birmingham, AL 35294-3412, USA
| | - Lindsay S Moore
- Department of Otolaryngology, University of Alabama at Birmingham, Faculty Office Tower 1155, 1720 2nd Avenue South, Birmingham, AL 35294-3412, USA
| | - Erika M Walsh
- Department of Otolaryngology, University of Alabama at Birmingham, Faculty Office Tower 1155, 1720 2nd Avenue South, Birmingham, AL 35294-3412, USA.
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Pagano R, Ingrosso C, Giancane G, Valli L, Bettini S. Wet Synthesis of Elongated Hexagonal ZnO Microstructures for Applications as Photo-Piezoelectric Catalysts. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E2938. [PMID: 32630074 PMCID: PMC7372467 DOI: 10.3390/ma13132938] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/23/2020] [Accepted: 06/26/2020] [Indexed: 12/11/2022]
Abstract
It is well known that energetic demand and environmental pollution are strictly connected; the side products of vehicle and industrial exhausts are considered extremely dangerous for both human and environmental health. In the last years, the possibility to simultaneously photo-degrade water dissolved pollutants by means of ZnO nanostructures and to use their piezoelectric features to enhance the photo-degradation process has been investigated. In the present contribution, an easy and low-cost wet approach to synthetize hexagonal elongated ZnO microstructures in the wurtzite phase was developed. ZnO performances as photo-catalysts, under UV-light irradiation, were confirmed on water dissolved methylene blue dye. Piezoelectric responses of the synthetized ZnO microstructures were evaluated, as well, by depositing them into films onto flexible substrates, and a home-made layout was developed, in order to stimulate the ZnO microstructures deposited on solid supports by means of mechanical stress and UV photons, simultaneously. A relevant increment of the photo-degradation efficiency was observed when the piezopotential was applied, proposing the present approach as a completely eco-friendly tool, able to use renewable energy sources to degrade water solved pollutants.
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Affiliation(s)
- Rosanna Pagano
- Department of Biological and Environmental Sciences and Technologies, DISTEBA, University of Salento, Via per Arnesano, I-73100 Lecce, Italy; (R.P.); (L.V.)
| | - Chiara Ingrosso
- CNR-IPCF Sez. Bari, c/o Department of Chemistry, University of Bari, via Orabona 4, I-70126 Bari, Italy;
| | - Gabriele Giancane
- Department of Cultural Heritage, University of Salento, Via D. Birago, 48, I-73100 Lecce, Italy
- Consorzio Interuniversitario Nazionale per la Scienza e Tecnologia dei Materiali, INSTM, Via G. Giusti, 9, I-50121 Firenze, Italy;
| | - Ludovico Valli
- Department of Biological and Environmental Sciences and Technologies, DISTEBA, University of Salento, Via per Arnesano, I-73100 Lecce, Italy; (R.P.); (L.V.)
- Consorzio Interuniversitario Nazionale per la Scienza e Tecnologia dei Materiali, INSTM, Via G. Giusti, 9, I-50121 Firenze, Italy;
| | - Simona Bettini
- Consorzio Interuniversitario Nazionale per la Scienza e Tecnologia dei Materiali, INSTM, Via G. Giusti, 9, I-50121 Firenze, Italy;
- Department of Engineering for Innovation, University of Salento, Via per Monteroni, I-73100 Lecce, Italy
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Tsikopoulos A, Tsikopoulos K, Doxani C, Vagdatli E, Meroni G, Skoulakis C, Stefanidis I, Zintzaras E. Piezoelectric or Conventional Osteotomy in Rhinoplasty? A Systematic Review and Meta-Analysis of Clinical Outcomes. ORL J Otorhinolaryngol Relat Spec 2020; 82:216-234. [PMID: 32320977 DOI: 10.1159/000506707] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 02/20/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Osteotomy of nasal bones in rhinoplasty is associated with postsurgical morbidities. Recent evidence has suggested that a surgical method applying piezoelectric ultrasound waves for nasal osteotomies in rhinoplasty reduces soft tissue damage and causes less postsurgical morbidities compared to conventional methods. The purpose of this study is to compare clinical outcomes of piezoelectric and conventional lateral nasal osteotomies in rhinoplasty. METHODS We searched PubMed, CENTRAL, and Web of Science up to 17 August 2019 for studies comparing postoperative outcomes of piezoelectric and conventional lateral osteotomies in rhinoplasty. We included studies comparing results of patients subjected to piezoelectric or conventional lateral nasal osteotomies in rhinoplasty. For outcomes, we considered postoperative pain, eyelid edema, periorbital ecchymosis, and intraoperative mucosal injury. RESULTS For eyelid edema, a statistically significant difference in favor of piezoelectric osteotomy was documented within the first 3 postoperative days (standardized mean difference [SMD] = -0.65; 95% CI = -1.18, -0.12, p = 0.02; I2 = 69%) and on postoperative day 7 (SMD = -0.69; 95% CI = -1.47, -0.09; p = 0.08; I2 = 85%). This was also the case for periorbital ecchymosis within the first 3 postoperative days (SMD = -0.85; 95% CI = -1.42, -0.28; p = 0.004; I2 = 72%) and on postoperative day 7 (SMD = -0.52; 95% CI = -0.79, -0.24; p = 0.0003; I2 = 71%). Intraoperative mucosal injury (OR = 0.06; 95% CI = 0.01, 0.53; p = 0.01; Ι2 = 0%) and postoperative pain (SMD = -0.99; 95% CI = -1.78, -0.11; p = 0.01; I2 = 49%) were also statistically lower during piezoelectric osteotomies. CONCLUSIONS This study shows that lateral piezoelectric osteotomy in rhinoplasty decreases postoperative pain, edema, ecchymosis, and intraoperative mucosa injuries compared to the conventional osteotomy technique with a chisel. Piezoelectric osteotomies are especially associated with less postoperative edema and ecchymosis in osteotomies not executed under direct vision.
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Affiliation(s)
- Alexios Tsikopoulos
- Laboratory of Biomathematics, School of Medicine, University of Thessaly, Larissa, Greece,
| | | | - Chrysoula Doxani
- Laboratory of Biomathematics, School of Medicine, University of Thessaly, Larissa, Greece
| | - Eleni Vagdatli
- Microbiology Department, Hippokration General Hospital, Thessaloniki, Greece
| | - Gabriele Meroni
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Charalambos Skoulakis
- Department of Otorhinolaryngology, School of Medicine, University of Thessaly, Larissa, Greece
| | - Ioannis Stefanidis
- Department of Nephrology, School of Medicine, University of Thessaly, Larissa, Greece
| | - Elias Zintzaras
- Laboratory of Biomathematics, School of Medicine, University of Thessaly, Larissa, Greece
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Cicciù M, Stacchi C, Fiorillo L, Cervino G, Troiano G, Vercellotti T, Herford AS, Galindo-Moreno P, Di Lenarda R. Piezoelectric bone surgery for impacted lower third molar extraction compared with conventional rotary instruments: a systematic review, meta-analysis, and trial sequential analysis. Int J Oral Maxillofac Surg 2020; 50:121-131. [PMID: 32284166 DOI: 10.1016/j.ijom.2020.03.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 01/27/2020] [Accepted: 03/11/2020] [Indexed: 12/14/2022]
Abstract
The aim of this study was to evaluate whether piezoelectric bone surgery (PBS) for impacted lower third molar extraction reduces the surgical time and risk of intra- and postoperative complications in comparison with conventional rotary instruments. This meta-analysis followed the PRISMA guidelines and was registered in the PROSPERO database. The PubMed, Embase, Scopus, and OpenGrey databases were screened for articles published from January 1, 1990 to December 31, 2018. Selection criteria included randomized controlled trials (RCTs) comparing PBS with conventional rotary instruments for impacted lower third molar extraction and reporting any of the clinical outcomes (intra- and postoperative complications and duration of surgery) for both groups. A risk of bias assessment was performed using the Cochrane Collaboration tool. A meta-analysis was performed, and the power of the meta-analytic findings was assessed by trial sequential analysis (TSA). Strong evidence suggests that PBS prolongs the duration of surgery and low evidence suggests that PBS reduces postoperative morbidity (pain and trismus) in comparison with rotary instruments. Data were insufficient to determine whether PBS reduces neurological complications and postoperative swelling in comparison with burs.
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Affiliation(s)
- M Cicciù
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
| | - C Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
| | - L Fiorillo
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy; Multidisciplinary Department of Medical, Surgical and Dental Specialities, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - G Cervino
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
| | - G Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - T Vercellotti
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| | - A S Herford
- Department of Maxillofacial Surgery, Loma Linda University, Loma Linda, California, USA
| | - P Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, University of Granada, Granada, Spain
| | - R Di Lenarda
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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Piezosurgery in Translabyrinthine-Approach Exposure of the Internal Auditory Canal. Otol Neurotol 2020; 41:554-559. [DOI: 10.1097/mao.0000000000002575] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
AIM The aim of this study was to investigate the effect of piezoelectric surgery (piezosurgery) on soft tissue in open septorhinoplasty. METHODS A total of 30 patients (21 females, 9 males; mean age 29.16 ± 8.17 years; range, 18-43 years) who underwent open septorhinoplasty between January 2019 and February 2019 were randomly divided into 2 groups. After the nasal dorsum was opened in all groups, 1 mm tissue under the skin in radix region was taken as punch biopsy. In the first group (classical group, n = 15), the cartilage hump was resected with number 15 scalpel and the bone hump with the help of a chisel. Lateral and median osteotomies were conducted using 4 mm sharp osteotomes. Rasping was performed to dorsum to correct bone deformities. Then, 1 mm punch biopsy was taken from under the skin tissue of the nose back near the radix. In the second group (piezo group, n = 15) hump excision, osteotomies and rasping were performed by piezoelectric surgery. Then, 1 mm punch biopsy was taken from the subcutaneous tissue of the nose back near the radix. Biopsies were examined histopathologically in the light microscope for edema, necrosis, and inflammation. RESULTS Of the 30 patients presented in this series, 21 were female and 9 were male. In the classical group, edema in the soft tissue was seen in 86.7% of the cases after osteotomy, while this rate was 26.7% in the piezosurgery group. The difference was statistically significant (P < 0.05). Although necrosis was not seen prior to the osteotomy in both groups, the rate of necrosis in the classical group was 13.3% and in the piezo group it was 66.7%. Necrosis was significantly different in the piezosurgery group compared with the classical osteotomy group (P < 0.05). CONCLUSION Piezosurgery is not completely harmless to soft tissue. A statistically significant increase in subcutaneous necrosis compared with the classical group can be explained by long-term soft tissue trauma caused by piezoelectric vibrations. We think that developing necrosis may cause problems in late period, especially in patients with thin skin.
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Mirza AA, Alandejani TA, Al‐Sayed AA. Piezosurgery versus conventional osteotomy in rhinoplasty: A systematic review and meta‐analysis. Laryngoscope 2019; 130:1158-1165. [DOI: 10.1002/lary.28408] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/25/2019] [Accepted: 10/26/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Ahmad A. Mirza
- Department of Otolaryngology, Head and Neck SurgeryFaculty of Medicine in Rabigh, King Abdulaziz University Jeddah Saudi Arabia
- Department of Otolaryngology, Head and Neck SurgeryFaculty of Medicine, King Abdulaziz University Jeddah Saudi Arabia
- Department of Community Medicine, Faculty of MedicineKing Abdulaziz University Jeddah Saudi Arabia
| | - Talal A. Alandejani
- Division of Otolaryngology, Department of SurgeryKing Saud bin Abdulaziz University for Health Sciences Jeddah Saudi Arabia
- King Abdullah International Medical Research Center Jeddah Saudi Arabia
- Division of Otolaryngology, Department of SurgeryMinistry of the National Guard–Health Affairs Jeddah Saudi Arabia
| | - Ahmed A. Al‐Sayed
- Department of Otolaryngology–Head and Neck SurgeryFaculty of Medicine, King Saud University Riyadh Saudi Arabia
- Division of Otolaryngology–Head and Neck Surgery, Department of SurgeryDalhousie University Halifax Nova Scotia Canada
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Kim DH, Kang H, Jin HJ, Hwang SH. Effect of piezoelectric osteotomy on postoperative oedema and ecchymosis after rhinoplasty. Clin Otolaryngol 2019; 44:968-974. [DOI: 10.1111/coa.13415] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 03/06/2019] [Accepted: 08/18/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Do Hyun Kim
- Department of Otolaryngology‐Head and Neck Surgery College of Medicine Seoul St. Mary's Hospital The Catholic University of Korea Seoul Korea
| | - Haram Kang
- Department of Otolaryngology‐Head and Neck Surgery College of Medicine Bucheon St. Mary's Hospital The Catholic University of Korea Seoul Korea
| | - Ho Jun Jin
- Department of Otolaryngology‐Head and Neck Surgery College of Medicine Bucheon St. Mary's Hospital The Catholic University of Korea Seoul Korea
| | - Se Hwan Hwang
- Department of Otolaryngology‐Head and Neck Surgery College of Medicine Bucheon St. Mary's Hospital The Catholic University of Korea Seoul Korea
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Abstract
BACKGROUND Postoperative periorbital edema and ecchymosis after rhinoplasty are mainly caused by the osteotomy with hammer and chisel. The introduction of piezoelectric surgery could lead to a better early postoperative outcome due to improved preservation of soft tissues. The aim of this systematic review was to evaluate the methods and results of studies comparing conventional osteotomy to piezoelectric osteotomy. METHODS A systematic literature search was conducted in the PubMed/MEDLINE and Google Scholar databases. In the primary selection, all studies on the comparison of conventional and piezoelectric osteotomies with regard to postoperative periorbital edema and/or ecchymosis were identified. Secondary selection included only study designs with a control group. RESULTS Primary selection resulted in 15 thematically relevant publications with a notable increase in annual publications between 2007 and 2017. Six studies with control groups were selected secondarily. Qualitatively and methodologically, the studies were very heterogeneous. The results of five of the six studies indicated a significant advantage of piezo technology compared to conventional osteotomy. Only in one study was no significant difference found in the investigated postoperative outcome. CONCLUSION Piezoelectric osteotomy resulted in a reduced propensity for postoperative edema and ecchymosis compared to the conventional osteotomy technique with a chisel. At this time, the results should be regarded as a trend. A definite recommendation favoring piezoelectric osteotomy cannot be made until more studies with higher patient numbers become available.
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Piezosurgery: Ten Years' Experience of Percutaneous Osteotomies in Rhinoplasty. J Oral Maxillofac Surg 2019; 77:1237-1244. [DOI: 10.1016/j.joms.2019.01.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 01/22/2019] [Accepted: 01/22/2019] [Indexed: 11/22/2022]
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Ultrasonic versus conventional gap arthroplasty for the release of ankylosis of temporomandibular joint: a prospective cohort study. Sci Rep 2019; 9:385. [PMID: 30674962 PMCID: PMC6344476 DOI: 10.1038/s41598-018-36955-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 11/23/2018] [Indexed: 11/10/2022] Open
Abstract
The purpose of this study was to compare the clinical outcomes of ultrasonic surgery to the conventional bone cutting technique using bur and saw for the release of ankylosis of temporomandibular joint. We conducted a prospective cohort study on 25 patients with 38 ankylotic joints at Chinese PLA General Hospital from March 01, 2012 to March 01, 2016. Patients were followed up at least 2 years postoperatively. The primary outcome was the intraoperative blood loss per joint. The secondary outcome was the long-term (≥2 years) improvement of maximum mouth opening. The blood loss was significantly reduced in the ultrasonic group compared to the conventional group (107.3 ± 62.3 ml vs. 186.3 ± 92.6 ml, P = 0.019). The long-term improvements of maximum mouth opening were substantial and stable in both groups (33.5 ± 4.8 mm in the ultrasonic group vs. 29.2 ± 6 mm in the conventional group, P = 0.06). Multivariate linear regression analysis showed a significant association between blood loss and technique used (coefficient: 66.3, 95% confidence interval: 22.1,110.4, P = 0.006). The ultrasonic surgery was associated with less intraoperative blood loss when compared to the conventional method for the release of ankylosis of temporomandibular joint while providing a stable and comparable long-term improvement of maximum mouth opening.
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New instrumentations in the operating room for sinus surgery. Curr Opin Otolaryngol Head Neck Surg 2018; 26:13-20. [DOI: 10.1097/moo.0000000000000433] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Centralised databases as a primer for research. The Journal of Laryngology & Otology 2017; 131:S1. [PMID: 28555537 DOI: 10.1017/s0022215117000950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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