Piezoelectric technology has been successfully employed, particularly in otology and skull base surgery, where its specific advantages versus traditional drills include a lack of 'blunting' and tissue selectivity. Technical advantages include ease of use, a short learning curve and improved visibility. Its higher cost warrants consideration given that clinically significant improvements in operative time and morbidity have not yet been proven. Further studies may define the evolving role of piezoelectric surgery in otolaryngology, and head and neck surgery.

Selecting a position 3 to 4 cm above the level of the EAC is more likely to result in dural exposure for a 3-mm BAHS abutment, especially in men. Selecting a position near the level of the EAC provides thicker bone, but the surgeon is more likely to encounter suture line or enter mastoid air cells. Preoperative CT imaging may be a useful tool in evaluating calvarial thickness and hazards when planning BAHS insertion in the adult population.

No abstract