J Neurol Surg B Skull Base 2015; 76 - P071
DOI: 10.1055/s-0035-1546699

Optimization of the Ultrasonic Bone Aspirator in Retrosigmoid Vestibular Schwannoma Removal

Justin S. Golub 1, Natalie R. Pottschmidt 1, Jon D. Weber 1, Mario Zuccarello 2, Myles L. Pensak 1, Norberto Andaluz 2, Ravi N. Samy 1
  • 1University of Cincinnati, Cincinnati, United States
  • 2University of Cincinnati/Mayfield Clinic, Cincinnati, United States

Introduction: Postoperative headache is a troublesome side effect of retrosigmoid vestibular schwannoma resection. The ultrasonic bone aspirator (UBA) has been shown in our laboratory to greatly reduce bone dust dispersion, which may subsequently reduce headache incidence. Speed of bone removal is an additional consideration in multidisciplinary skull base surgery. The optimal UBA tips for minimizing bone dust dispersion and maximizing bone removal rate are unknown.

Methods: Temporal bone blocks were placed in a watertight container. Bone was ablated with the UBA under timed conditions. Four different bone removal tips were employed. The power of the UBA was also varied. The irritant containing bone dust was microfiltrated and the bone dust was weighed. Differences were compared across groups with ANOVA and the two-tailed t-test.

Results: The Payner 360 tip resulted in the most bone dust dispersion (57% at 15% power and 76% at 100% power; n = 12). The Claw tip resulted in the least dispersion (7% at 15% power and 38% on 100% power; n = 12). This was significantly different (p < 0.01). However, there was a trend toward decreased ablation rate with the Claw.

Conclusion: The Claw tip resulted in the least bone dust dispersion, but with a relatively decreased bone removal rate. Use of tips that minimize bone dust dispersion may have implications for reducing headache in the retrosigmoid approach. The extra duration for minimizing bone dust dispersion with appropriate UBA tips may be offset by potentially decreased postoperative symptoms.