1,721,274 research outputs found
Clinical evaluation of piezoelectric ear surgery
No full textAbstract
We evaluated the use of piezoelectric surgery (Piezosurgery;
Mectron Medical Technology; Carasco, Genoa, Italy) as a
means of avoiding some complications of osteotomy and
osteoplasty in otologic surgery, particularly in classic canalwall-
up mastoidectomy. Piezoelectric surgery is a recently
developed system for cutting bone with microvibrations
created by the piezoelectric effect. This effect occurs when
an electric current is passed through certain ceramics and
crystals, causing them to oscillate at ultrasonic frequencies.
OUT study population was made up of 20 adults with
unilateral chronic otitis media. In all patients, piezoelectric
surgery allowed for effective, precise, safe, easy, and rapid
intraoperative management. Inparticular, the instrument's
precision allowed surgeonsto make exact, clean, and smooth
cuts without causing any injury to adjacent soft tissue. No
complications were noted. We conclude that the piezoelectric
device is superior to conventionally rotating instruments
for performing classic canal-wall-up mastoidectomy
Piezosurgery in the excision of middle ear tumors: effects on mineralized and non mineralized tissues
No full textBACKGROUND:
Piezosurgery is a new instrument able to cut bone without necrosis and non-mineralized tissue damage. The aim of this study was to test the Piezosurgery as a new and alternative method for the excision of middle-ear tumors and to analyze its effects on soft tissues.
MATERIAL/METHODS:
The Piezosurgery device was used to excise eight glomus tympanicum tumors and two primary B-cell lymphomas of the middle ear. The piezoelectric device uses low-frequency ultrasonic waves (24.7-29.5 kHz); the applied power can be modulated between 2.8 and 16 W and is programmed in accordance to the density of the bone. The equipment consists of two hand-pieces, two inserts, and two peristaltic pumps. The microvibrations that are created in the piezoelectric hand-piece cause the inserts to vibrate linearly by between 60 and 210 microm.
RESULTS:
Piezosurgery provided excellent control in all the patients, without bleeding and harmful effects on the adjacent structures of the middle and inner ear.
CONCLUSIONS:
Piezosurgery is a new and revolutionary osteotomy technique utilizing the microvibrations of scalpels at ultrasonic frequency, so that soft tissue will not be damaged even upon accidental contact with the cutting tip. The vibration frequency of Piezosurgery is optimal for mineralized tissue and does not cut the adjacent soft tissue, minimizing the risk of harming the adjacent tissues. This renders the piezoelectric device ideal for application at the border between hard and soft tissues as in the excision of a middle-ear tumor
Binocular flash-induced nystagmus in humans
No full textObjective: The aim of this study was to demonstrate that binocular flash-induced nystagmus (B-FIN) can be evoked in humans. Design: The study evaluated the presence of B-FIN by stimulation with a stroboscopic flash. Setting: The study was conducted with 12 healthy patients in the Otorhinolaryngology Department of the University of Genoa (Italy), between April 2008 and January 2009. Methods: Patients underwent binocular flashing light stimulation, in the dark, by stroboscopic flash presented through a photostimulator at frequencies of 4.7 and 7.69 cycles/second for 120 seconds, with their eyes covered by a homogeneous field hollow opal hemisphere. The photostimulator was placed in three different positions with respect to the anterior-posterior axis: 0u, 45u to the right, and 45u to the left. Main Outcome Measures: Eyemovementswere recorded by electronystagmography (ENG). ENGrecording started 30 seconds before the stimulation and stopped 60 seconds after the end of the luminance stimuli to test the presence of flash induced after nystagmus (FIAN). Results: B-FIN was clearly evoked from 10 of the 12 healthy adults, whereas FIAN was evoked from 4 of the 12 subjects. The best stimulation of B-FIN was obtained through an intermittent luminance stimulus presented at a frequency of 4.7 cycles/second and the photostimulator placed at 0u to the optic axis. Conclusions: Our investigation demonstrates that B-FIN can be evoked in humans and its possible value in the differential diagnosis between central and peripheral vertigo
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Effects of Piezosurgery on the cochlear outer hair cells.
No full textThe absence of audiologic side effects highlights the reduced trauma of the piezoelectric cut, demonstrates the superiority of the Piezosurgery device in terms of safety and protection of anatomical structures and confirms its applicability in all the otologic techniques tested. OBJECTIVES: The aim of the present study was to estimate the effect of Piezosurgery on the cochlea and in particular on the cochlear outer hair cells. PATIENTS AND METHODS: We selected 60 patients with a history of otologic surgery with Piezosurgery. Before and 6 months after surgery, all the patients underwent the following instrumental examinations: pure-tone audiometry, tympanometry, transient evoked otoacoustic emissions (TEOAEs), distortion product otoacoustic emissions (DPOAEs) and auditory brainstem response (ABR). RESULTS: Piezosurgery showed its safety on the inner ear and in particular on the cochlear outer hair cells: for each instrumental examination (pure-tone audiometry, tympanometry, TEOAE, DPOAEs and ABR), no patients presented postoperative worsenin
Results of revision mastoidectomy with Piezosurgery®
No full textObjectives: The aim of this study was to determine the efficiency of the piezoelectric device in revision surgery for chronic otitis media. Methods: A total of 30 patients had revision mastoidectomy with previous canal wall up mastoidectomy. The piezoelectric device was used in all intraoperative steps. Before surgery and 1 month and 1 year after surgery, all the patients underwent the following instrumental examinations: pure-tone audiometry, tympanometry, transient-evoked otoacoustic emissions, distortion product otoacoustic emissions, auditory brainstem response, and electronystamographic recording. Results: The piezoelectric device provided effective cutting, with excellent control and without side effects on the adjacent structures of the middle and inner ear (lateral sinus, facial nerve, and/or dura mater). Postoperatively, all patients had an uneventful recovery with no evidence of audiovestibular deficit or side effects. Among 30 cases followed for 1 year, 29 (97%) maintained a dry and safe ear. Intermittent otorrhea with perforation of the tympanic membrane occurred in one patient (3%). Conclusion: For otologic revision surgery, the advantage of the piezoelectric device appears real because it is possible to perform a 'blind' cutting of bone with fewer precautions necessary for soft tissues such as the facial nerve, lateral sinus, and dura mater
Sulphurous thermal water inhalations in the treatment of chronic rhinosinusitis
No full textThe aim of this study was to evaluate the efficiency of sulphurous thermal water in the treatment of chronic rhinosinusitis (CRS). Eighty patients with CRS were included and randomly assigned into two groups. Patients underwent a 12-day course of warm vapour inhalations and nasal irrigations with sulphurous thermal water in group A, and a physiological solution in group B. Compared with group B, in group A the results were as follows: serum concentration of IgE was significantly lower (p < 0.05) 12 days (76.27 ± 26.3 mg/dl vs. 97.44 ± 45.4) and 3 months after the beginning of the treatment (75.48 ± 26.1 mg/dl vs. 98.37 ± 41.4); IgA titers were not significantly higher 12 days (231.09 ± 120.3 mg/dl vs. 220.44 ± 114.4 mg/dl) and 3 months after the beginning of the treatment (235.44 ± 118.5 mg/dl vs. 214.51 ± 111.8 mg/dl); VAS scores were significantly (p < 0.05) improved at 12 days (1.7 ± 0.18 vs. 6.9 ± 0.51) and 3 months after the start (1.8 ± 0.22 vs. 7.1 ± 0.59); NMTT was normal at 12 days (11.54 ± 1.59 min vs. 17.38 ± 1.83 min) and 3 months after the beginning of the treatment (11.46 ± 2.07 min vs. 17.43 ± 2.01 min); total nasal resistances were significantly (p < 0.05) decreased at 12 days and 3 months. Our results indicate the efficiency and applicability of sulphurous thermal water in the treatment of CRS
Piezosurgery® for removal of symptomatic ear osteoma
No full textPiezosurgery® is an ultrasound instrument (24.7-29.5 kHz) that is able to cut the bone without necrosis and nonmineralized tissue damage. The aim of this work has been to determine the applicability and efficiency of the piezoelectric device in the excision of symptomatic ear osteomas. 10 patients affected by osteoma of the external auditory canal (EAC) (6 right, 4 left) were enrolled. Patients underwent excision of the EAC osteoma through a transcanal approach, with the piezoelectric device. Before and 6 months after surgery, all the patients underwent pure-tone audiometry, tympanometry, transient-evoked otoacoustic emissions, distortion product otoacoustic emissions, auditory brainstem response, and electronystamographic recording. The piezoelectric device provided excellent control without side effects on the adjacent structures of the external, middle and inner ear. The piezoelectric device is a new bony scalpel using the microvibrations at ultrasonic frequency so that soft tissue (nerve, vessel, dura mater, skin, etc.) will not be damaged even on accidental contact with the cutting tip. A feature of the piezoelectric device is its good manageability, which makes it easy for a well-trained otologic surgeon to create a straight osteotomy line: this renders the piezoelectric device suitable for bone surgery and for removal osteomas of the EAC
Piezoelectric stapedotomy: the importance of a micropulse program
No full textObjectives: The aim of this study was to describe the importance of a micropulse program in determining the success of piezoelectric stapedotomy. Methods: A total of 112 patients (group A) affected by primary otosclerosis underwent piezoelectric stapedotomy for otosclerotic stapes fixation. A specific operative program was created to perforate the stapes footplate: this program makes it possible to perforate the footplate of the stapes with a predetermined and non-modifiable temporization. Before and 1 year after surgery, all the patients underwent the following instrumental examinations: pure-tone audiometry, tympanometry, transient-evoked otoacoustic emissions, distortion product otoacoustic emissions, and auditory brainstem response. Results were compared with those obtained from 30 patients who underwent piezoelectric stapedotomy without the specific operative program (group B). Results: At 1 year after surgery, with regard to the pure-tone audiometry test, all patients had an air-bone gap (ABG) reduction: no worsening of the bone conduction and no postoperative sensorineural hearing loss were found. In group A, there was a closure of the ABG within 10 dB in all patients. Conclusions: We can consider the micropulse program as the best level of safety that should be used in all cases of piezoelectric stapedotomy
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