Piezosurgery for exposure of the internal auditory canal in translabyrinthine approach
23 April 2019 (online)
The removal of the bone around the internal auditory canal requires from the surgeon a lot of patience and good three-dimensional orientation in the complex anatomical topography. In the present study, the eligibility of the piezoelectric device for this critical surgical step was investigated.
During the translabyrinthine approach for vestibular schwannoma, the classical technique (rotating burr) for the opening of the internal auditory canal was compared with piezoelectric surgery (oscillating saw-blade). The evaluation was carried out by an experienced and an unexperienced surgeon.
Irrespective of the surgical experience, piezosurgery proved to be a precise and safe technique for exposure of the internal auditory canal. Compared to the rotating burr, it was easier and more comfortable. The differences with respect to the risk of accidental slipping off and any consequent thermal and mechanical impact on the neural structures as well as in the handling of both devices are discussed.
The exposure of the internal auditory canal by means of an oscillating piezoelectric saw is a safe technique that could reduce the risk of injury to the nerve structures.