A novel approach to facial nerve decompression: use of Piezosurgery.

ABSTRACT

CONCLUSIONS: The safety of Piezosurgery as regards soft tissues in facial nerve decompression was confirmed. No side effects were detected during unintentional contact with the nerve. OBJECTIVES: The aim of this work was to test Piezosurgery as a new and alternative method to conventional bone tissue management in facial nerve decompression by posterior tympanotomy. PATIENTS AND METHODS: We used Piezosurgery under general anaesthesia on 10 patients affected by facial paralysis following temporal bone fractures. The equipment consists of two hand-pieces, two inserts and two peristaltic pumps connected to the control unit. The device uses low frequency ultrasonic waves (24.7-29.5 kHz), the applied power can be modulated between 2.8 and 16 W, and the machine is programmed in accordance with the density of the bone. The micro-vibrations that are created in the piezoelectric hand-piece cause the inserts to vibrate linearly between 60 and 210 microm. RESULTS: Piezosurgery proved effective in sclerotic and pneumatic mastoid. This approach results in significantly less operative blood loss and better visibility in the surgical field compared with conventional methods. Its safety as regards soft tissues was confirmed no side effects were detected during unintentional contact with the nerve. All patients presented a complete recovery from facial paralysis at the last follow-up.