The Impact of Piezoelectric Device in Cholesteatoma Endoscopic Surgery: Retrospective Evaluation of Safety and Functional Results.

Autor:	Marchioni D; Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Modena, Modena, Italy., Ronzani G; Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Verona, Verona, Italy., Gazzini S; Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Verona, Verona, Italy., Fulco G; Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Verona, Verona, Italy., Rubini A; Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Modena, Modena, Italy.
Jazyk:	angličtina
Zdroj:	Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology [Otol Neurotol] 2024 Jun 01; Vol. 45 (5), pp. e420-e426.
DOI:	10.1097/MAO.0000000000004181
Abstrakt:	Objective: Atticotomy represents an essential surgical step within the management of attical cholesteatoma during endoscopic ear surgery. The aim of the present study was to evaluate the safety and functional results of an endoscopic atticotomy performed with piezosurgery, in terms of audiological outcomes and tissue's healing. Methods: This is an observational retrospective study on patients with attical cholesteatoma who underwent endoscopic ear surgery with piezoelectric atticotomy and subsequent scutum reconstruction either with tragal cartilage or temporalis muscle fascia. Scutumplasty's status was evaluated via scheduled outpatient controls through an endoscopic check and classified as stable or unstable at least 10 months after surgery. A pre- and postoperative audiometric examination was performed in each patient. Results: Eighty-four patients were enrolled. In 50 out of 84 patients (59.52%), an exclusive endoscopic procedure was performed, whereas in 34 patients (40.48%) a combined microscopic/endoscopicapproach was adopted. In 72 cases (85.71%), scutum's reconstruction appeared to be normally positioned, whereas 12 patients developed a retraction pocket, which was self-cleaning in 8 of them and non-self-cleaning in the remaining 4. In 17 patients, a slight sensorineural hearing loss (between 5 and 15 dBHL) was observed, and in 2 patients, the loss was greater than 15 dBHL. Overall, no significative differences between pre- and postoperative pure-tone average bone thresholds resulted (p = 0.4983), though a mild significant hearing deterioration was detected by the specific analysis at 4000 Hz (p = 0.0291). Conclusion: Piezosurgery represents an extremely useful tool in performing atticotomy during endoscopic tympanoplasties. Our data seem to support the safety of its usage in this specific step, as it did not lead to any significant sensorineural damage on overall pure-tone average. Moreover, satisfactory tissue healing in regard to scutum reconstruction was observed. Competing Interests: The authors have no conflicts of interest to declare. The authors disclose no conflicts of interest. (Copyright © 2024, Otology & Neurotology, Inc.)
Databáze:	MEDLINE
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