A comparative analysis of the application of piezoelectric surgery and mechanical osteoperforation techniques in modeling an orbital decompression

Abstract

Currently a wide range of instruments for surgical procedures on the bony structures of the orbits is offered. Each of them has its advantages and disadvantages. Cutter causes less injury, in comparison with a chisel or an ultrasonic saw [15]. In using a drill during surgery there was an increase in temperature of bone edge of the opening above acceptable values [17]. The use of low frequency ultrasonic tools allows you to create holes in the bones of any desired size and shape with smooth edges [5, 11, 16, 20]. The disadvantages of this method include the heating of tool’s tip up to 140° during prolonged continuous action [6]. Thus, techniques using tools for formation of the bone window require further study and improvement. Aim: to compare surgical equipment for bone window formation in modeling an orbital decompression. Materials and methods. In an experimental study in vivo, 12 surgical interventions on the scapula on both sides were performed in 6 Chinchilla breed rabbits. On the right side, the formation of a bone window was carried out by the ultrasonic bone scalpel MISONIX, on the left side - by a drill. Results. It was found that during first 7-21 days there was more pronounced inflammation of soft tissues on the left side. At the same time, delayed proliferation and maturation of fibrous connective tissue was observed in comparison to the opposite side. Bone tissue inflammation and subsequent regeneration took place without significant differences on both sides. The experiment showed that the use of ultrasonic scalpel in flat bones creates less inflammation of surrounding tissues and the bone itself as compared to a diode laser. A.V. Kravchenko (2006) reports that, after exposure to a diode laser in an acute experiment there was a scalloped edge with an area of photocarbonization (charring) on the 7th and the 21st day; while the use of an ultrasonic scalpel did not create any signs of infiltrative inflammation, later on a nonspecific inflammation developed. Conclusion. Ultrasonic scalpel has a number of advantages when performing osteoperforation, such as time-saving during surgical procedure, control of the osteotomy process, less trauma to surrounding tissues during action and less pronounced inflammatory response of the wound during early postoperative period. (For citation: Konovalov KA, Davydov DV, Roshchin VY. A comparative analysis of the application of piezoelectric surgery and mechanical osteoperforation techniques in modeling an orbital decompression. Ophthalmology Journal. 2018;11(1):10-18. doi: 10.17816/OV11110-18).

The Safety of Diagnostic Ultrasound in Ophthalmology

“…И.Н. Субботина предложила использовать «ультразвуковой нож» для выполнения дакриоцисториностомии [20]. В работе М.Б.…”