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Thermal injury from mastoid bone burrs
The Annals of Otology, Rhinology, and Laryngology
|January 1, 1978
Summary
Continuous irrigation is crucial during bone drilling to prevent dangerous temperature increases and protect the facial nerve. Unirrigated cutting and diamond burrs can cause significant thermal injury, impacting surgical outcomes.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Surgical Technology
Background:
- Bone cutting and drilling procedures can generate significant heat.
- Elevated temperatures pose a risk to vital structures like the facial nerve.
- Osteocyte necrosis and thermal injury are potential complications of surgical drilling.
Purpose of the Study:
- To investigate the thermal effects of cutting and diamond burrs during bone drilling.
- To determine the impact of irrigation on bone and nerve temperatures.
- To elucidate the factors influencing heat generation by different burr types.
Main Methods:
- Experimental analysis of cutting and diamond burrs under various conditions (speed, pressure, flutes).
- Temperature monitoring of bone and simulated nerve tissue during drilling with and without irrigation.
- Histological examination of bone surface for osteocyte necrosis.
Main Results:
- Cutting and diamond burrs without irrigation cause marked bone temperature elevations and osteocyte necrosis.
- Generated temperatures can injure the facial nerve even at a distance.
- Irrigation effectively maintains bone and nerve temperatures within safe limits.
- Cutting burr heat increases with speed, pressure, and contact area; diamond burr heat depends on pressure only.
- Revascularization originates from periosteum, unaffected by surface thermal injury.
Conclusions:
- Continuous irrigation is essential to mitigate thermal risks during bone drilling.
- Understanding burr thermodynamics is key to minimizing surgical complications.
- Surface thermal injury does not hinder bone graft healing or revascularization.