Ultrasonic bone removal from the ossicular chain affects cochlear structure and function
Abstract Introduction Ultrasonic bone removal devices (UBD) are capable of cutting through bony tissue without injury to adjacent soft tissue. The feasibility and safety of using this technology for removal of bone from an intact ossicular chain (as might be required for otosclerosis or congenital f...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2021-04-01
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| Series: | Journal of Otolaryngology - Head and Neck Surgery |
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| Online Access: | https://doi.org/10.1186/s40463-021-00491-4 |
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| author | Jennifer M. Siu Jaina Negandhi Robert V. Harrison Nikolaus E. Wolter Adrian James |
| author_facet | Jennifer M. Siu Jaina Negandhi Robert V. Harrison Nikolaus E. Wolter Adrian James |
| author_sort | Jennifer M. Siu |
| collection | DOAJ |
| description | Abstract Introduction Ultrasonic bone removal devices (UBD) are capable of cutting through bony tissue without injury to adjacent soft tissue. The feasibility and safety of using this technology for removal of bone from an intact ossicular chain (as might be required for otosclerosis or congenital fixation) was investigated in an animal model. Methods This was a prospective animal study conducted on seven anesthetised adult chinchillas. An UBD was used to remove bone from the malleus head in situ. Pre and post-operative distortion product otoacoustic emission (DPOAE) levels and auditory brainstem response (ABR) thresholds were recorded. Scanning electron microscopy (SEM) was used to assess cochlear haircell integrity. Results Precise removal of a small quantity of bone from the malleus head was achieved by a 30s application of UBD without disruption of the ossicular chain or tympanic membrane. DPOAEs became undetectable after the intervention with signal-to-noise ratios (SNR) < 5 dB SPL in all ears. Furthermore, ABR thresholds were elevated > 85 dB SPL in 13 ears. SEM showed significant disruption of structural integrity of the organ of Corti, specifically loss and damage of outer haircells. Conclusions Although UBD can be used to reshape an ossicle without middle ear injury, prolonged contact with the ossicular chain can cause structural and functional injury to the cochlea. Extensive cochlea pathology was found, but we did not investigate for recovery from any temporary threshold shift. In the authors’ opinion, further study should be undertaken before consideration is given to use of the device for release of ossicular fixation. Graphical abstract |
| format | Article |
| id | doaj-art-12299bff480e490eaed40229f4409978 |
| institution | Kabale University |
| issn | 1916-0216 |
| language | English |
| publishDate | 2021-04-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Otolaryngology - Head and Neck Surgery |
| spelling | doaj-art-12299bff480e490eaed40229f44099782025-02-03T10:51:14ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162021-04-015011810.1186/s40463-021-00491-4Ultrasonic bone removal from the ossicular chain affects cochlear structure and functionJennifer M. Siu0Jaina Negandhi1Robert V. Harrison2Nikolaus E. Wolter3Adrian James4Department of Otolaryngology - Head & Neck Surgery, University of TorontoProgram in Neuroscience and Mental Health, Hospital for Sick ChildrenDepartment of Otolaryngology - Head & Neck Surgery, University of TorontoDepartment of Otolaryngology - Head & Neck Surgery, University of TorontoDepartment of Otolaryngology - Head & Neck Surgery, University of TorontoAbstract Introduction Ultrasonic bone removal devices (UBD) are capable of cutting through bony tissue without injury to adjacent soft tissue. The feasibility and safety of using this technology for removal of bone from an intact ossicular chain (as might be required for otosclerosis or congenital fixation) was investigated in an animal model. Methods This was a prospective animal study conducted on seven anesthetised adult chinchillas. An UBD was used to remove bone from the malleus head in situ. Pre and post-operative distortion product otoacoustic emission (DPOAE) levels and auditory brainstem response (ABR) thresholds were recorded. Scanning electron microscopy (SEM) was used to assess cochlear haircell integrity. Results Precise removal of a small quantity of bone from the malleus head was achieved by a 30s application of UBD without disruption of the ossicular chain or tympanic membrane. DPOAEs became undetectable after the intervention with signal-to-noise ratios (SNR) < 5 dB SPL in all ears. Furthermore, ABR thresholds were elevated > 85 dB SPL in 13 ears. SEM showed significant disruption of structural integrity of the organ of Corti, specifically loss and damage of outer haircells. Conclusions Although UBD can be used to reshape an ossicle without middle ear injury, prolonged contact with the ossicular chain can cause structural and functional injury to the cochlea. Extensive cochlea pathology was found, but we did not investigate for recovery from any temporary threshold shift. In the authors’ opinion, further study should be undertaken before consideration is given to use of the device for release of ossicular fixation. Graphical abstracthttps://doi.org/10.1186/s40463-021-00491-4Ultrasonic bone removalPiezosurgerySafety |
| spellingShingle | Jennifer M. Siu Jaina Negandhi Robert V. Harrison Nikolaus E. Wolter Adrian James Ultrasonic bone removal from the ossicular chain affects cochlear structure and function Journal of Otolaryngology - Head and Neck Surgery Ultrasonic bone removal Piezosurgery Safety |
| title | Ultrasonic bone removal from the ossicular chain affects cochlear structure and function |
| title_full | Ultrasonic bone removal from the ossicular chain affects cochlear structure and function |
| title_fullStr | Ultrasonic bone removal from the ossicular chain affects cochlear structure and function |
| title_full_unstemmed | Ultrasonic bone removal from the ossicular chain affects cochlear structure and function |
| title_short | Ultrasonic bone removal from the ossicular chain affects cochlear structure and function |
| title_sort | ultrasonic bone removal from the ossicular chain affects cochlear structure and function |
| topic | Ultrasonic bone removal Piezosurgery Safety |
| url | https://doi.org/10.1186/s40463-021-00491-4 |
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