Ultrasonic Bone Removal With the Sonopet Omni

Sivak-Callcott, Jennifer A.; Linberg, John V.; Patel, Sarit

doi:10.1001/archopht.123.11.1595

Cited by 58 publications

(14 citation statements)

References 3 publications

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“…In our experience, this results in less soft tissue damage and less torque-induced bone fragment displacement, which could lead to paralytic strabismus, anisocoria, or accommodation problems [7], protecting critical areas such as the dura mater and the neurovascular bundles in the narrow environment of the orbit. The ability to easily sculpt bone into a contoured shape with minimal bleeding and minimal postoperatory inflammation is particularly advantageous in orbital surgery [24, 27, 29]. We agree with Cho et al that, due to these advantages, it can be safely used in tighter surgical spaces, decreasing the need to remove the lateral orbital rim [19].…”

Section: Discussionmentioning

confidence: 58%

“…The oscillation produced by the SONOPET® only affects the tissues when they are in contact with the tip, without causing any movement of the surgeon's hand [19]. Because of the nonrotational design, soft tissues and cottonoid pledgets are not grabbed and spun by the tip, and there is little or no torque, both potentially negative features of a standard drill [24, 29]. In our experience, this results in less soft tissue damage and less torque-induced bone fragment displacement, which could lead to paralytic strabismus, anisocoria, or accommodation problems [7], protecting critical areas such as the dura mater and the neurovascular bundles in the narrow environment of the orbit.…”

Section: Discussionmentioning

confidence: 99%

“…There are only a few authors who have reported partial rim sparing (PRS) using a high- speed drill [20] or high-speed drill and rongeurs [5, 23]. The first report of ultrasonic bone removal in the orbit was performed by Sivak-Callcott et al [24] who used the SONOPET® in 13 lateral orbital decompressions and 6 external dacryocystorhinostomies. Cho et al [19] reported a further 18 orbital decompressions in 2010.…”

Section: Introductionmentioning

confidence: 99%

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Deep Lateral Wall Partial Rim-Sparing Orbital Decompression with Ultrasonic Bone Removal for Treatment of Thyroid-Related Orbitopathy

Bengoa-González

Galindo‐Ferreiro

Mencía‐Gutiérrez

et al. 2019

Journal of Ophthalmology

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Purpose To describe the results of thyroid-related orbitopathy (TRO) treated by ultrasonic deep lateral wall bony decompression with partial rim sparing (DLW-PRS). Methods A review was carried out, from January 2015 to September 2017, of all patients treated with ultrasonic DLW-PRS decompression using a SONOPET® (Stryker, Kalamazoo, MI, USA) ultrasonic aspirator, using a lateral, small triangle flap incision for access. The primary outcome was the change in proptosis (measured by the difference in Hertel exophthalmometry measurements). Other secondary outcomes were changes in visual acuity (VA) (using Snellen scale, decimal fraction), presence of lagophthalmos, eyelid retraction (measured by upper eyelid margin distance to the corneal reflex (MRD1) and lower eyelid margin distance to the corneal reflex (MRD2), and presence of exposure keratopathy). Results A total of 58 orbital decompressions in 35 patients were reviewed, with 23 patients (65.7%) having bilateral decompressions. There was a female preponderance with 26 patients (74.2%), and the mean age ± standard deviation was 52.6 ± 13.9 years. Mean proptosis was 24.51 ± 1.76 mm preoperatively, reduced to 19.61 ± 1.27 mm in final follow-up. The mean reduction was 4.9 ± 1.54 mm. VA improved from 0.8 ± 0.14 to 0.9 ± 0.12, p=0.039. 5 of 13 patients (38.4%) with preoperative diplopia reported improvement or complete resolution after surgery. MRD1 was reduced from 5.25 ± 0.88 mm to 4.49 ± 0.7 mm. MRD2 was also reduced from 6.3 ± 0.88 mm to 5.0 ± 0.17 mm. Presence of lagophthalmos was reduced from 35 eyes (60.3%) to five (8.6%); the presence of epiphora was also reduced from 20 patients (57.1%) to 3 (8.5%) following decompression. Complications of the surgery included zygomatic hypoaesthesia in 14 (40%) patients in the early postoperative period and chewing alterations in 10 (28.5%) of the patients. All of these complications were resolved at the 6-month follow-up visit. We noted no surgical complications such as ocular or soft tissue damage, infection, inflammation, or visual loss. Conclusions The SONOPET® ultrasonic bone curette can be used safely and effectively for DLW orbital decompression surgery. The main benefits were good visualization and handling of tissues and speed and ease of use of the equipment. This trial is registered with ClinicalTrials.gov identifier: NCT04025034.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Deep Lateral Wall Partial Rim-Sparing Orbital Decompression with Ultrasonic Bone Removal for Treatment of Thyroid-Related Orbitopathy

Bengoa-González

Galindo‐Ferreiro

Mencía‐Gutiérrez

et al. 2019

Journal of Ophthalmology

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“…Первичное расширение костного «окна» традиционно проводят при помощи выкусывателей, а его дальнейшее увеличение кзади и кверху различными высокоскоростными устройствами (пилы, боры, фрезы). В последние годы в научной литературе появились единичные сообщения об использовании ультразвуковых систем, в частности системы Sonopet, при декомпрессии орбиты как альтернатива высокоскоростной дрели [4,5]. Преимущество данной системы заключается в избирательном воздействии на различные по плотности виды ткани (мягкая, фиброзированная, кальцинированная, костная) [6].…”

Section: Information About the Authorsunclassified

Comparative electron microscopy study of the bone surfaces relief after ultrasonic and mechanical high-speed bone removal in orbital decompression

et al. 2019

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Цель исследования-провести сравнительное сканирующее электронно-микроскопическое исследование поверхностей костных фрагментов наружной стенки орбиты после воздействия механического и ультразвукового остеодеструкторов. Материал и методы. Исследованы поверхности 7 костных фрагментов, полученных в ходе костной декомпрессии орбиты у пациентов с эндокринной офтальмопатией (ЭОП). Проведено электронно-микроскопическое исследование костного рельефа после воздействия ультразвуковой хирургической системы и высокоскоростной дрели. Результаты. При проведении сканирующей электронной микроскопии было выявлено, что рельеф костной поверхности в пределах компактного вещества после воздействия ультразвукового аппарата характеризовался однотипными, параллельно расположенными бороздками глубиной до 100 мкм и шириной 80-100 мкм, имеющими относительно ровные края. В зоне воздействия на губчатое вещество костная поверхность становилась более аморфной, шероховатой за счет обнажения ячеистых структур на различной глубине. При воздействии дрели в высокоскоростном режиме в области компактного вещества определяли однообразный практически ровный рельеф с отдельными компактными конгломератами костной «пыли». После удаления истонченных фрагментов компактного вещества образца появлялась типичная ячеистая структура губчатого вещества. Заключение. Впервые полученные нами данные об особенностях рельефа краев костного «окна», специфика работы в условиях ограниченного операционного доступа позволили нам сделать вывод о перспективности современной ультразвуковой остеофрагментации при глубокой декомпрессии наружной стенки орбиты и ряде других орбитальных вмешательствах. Ключевые слова: ультразвуковая остеодеструкция, высокоскоростная механическая остеодеструкция, костная декомпрессия орбиты, эндокринная офтальмопатия, сканирующая электронная микроскопия.

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“…The use of rotary instrumentation in tight spaces, such as those available in orbital surgery, carries the not negligible risk of catching soft orbital tissues or damaging the dura. Ultrasonic bone removal recently proposed for orbital surgery represents a promising field of technical development [40]. Hand pieces which transmit 25-29 kHz vibrations can easily selectively carve/cut only mineralized tissues.…”

Section: Are Technical Developments In Surgical Approaches To Be Expementioning

confidence: 99%

Future Developments

Salvi

Baldeschi

2010

Graves' Orbitopathy

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Ultrasonic Bone Removal With the Sonopet Omni

Cited by 58 publications

References 3 publications

Deep Lateral Wall Partial Rim-Sparing Orbital Decompression with Ultrasonic Bone Removal for Treatment of Thyroid-Related Orbitopathy

Deep Lateral Wall Partial Rim-Sparing Orbital Decompression with Ultrasonic Bone Removal for Treatment of Thyroid-Related Orbitopathy

Comparative electron microscopy study of the bone surfaces relief after ultrasonic and mechanical high-speed bone removal in orbital decompression

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