Piezoelectric surgical device in endoscopic sinus surgery: an initial clinical experience

Revision endoscopic sinus surgery presents special challenges, such as the need to remove thick osteoneogenic bone close to the orbit or skull base. Currently available drills and microdebriders have shortcomings for this task, including risk to the underlying periorbita or dura. Recently, piezoelectric ultrasound technology has been used to remove bone while preserving adjacent soft tissue structures. This technology has been effective in several areas of the body, and it logically follows that it may have beneficial rhinologic applications. The purpose of this medical communication is to report an initial clinical experience with piezoelectric technology in revision sinus surgery. The piezoelectric surgical device was used during revision endoscopic sinus surgery in 14 patients in the author's practice from June 2006 to January 2009. All patients had an underlying bone component to their sinus condition, such as osteoneogenesis adjacent to the orbit or skull base. The piezoelectric surgical device performed successfully in removing osteoneogenic bone, and no complications were noted from its use. Piezoelectric surgical technology generates low-frequency ultrasound that dissects bone and appears to offer an option to mechanical drill instrumentation when used during endoscopic sinus surgery to address thick osteoneogenic bone. The clinical experience reported herein shows initial feasibility of the technology in selected cases of sinus surgery. On the basis of the favorable observations from this clinical experience, further exploration and discussion would appear to be valuable.