Piezoelectric device use in sinus osteotomy for equines is feasible but may extend time to accomplish frontonasal bone flap.

Overview

• This study evaluated the use of a piezoelectric device compared to a traditional oscillating bone saw for performing sinus osteotomy in horses.
• The research found that while the piezoelectric device is feasible and causes less trauma, it requires more surgical time to complete the procedure.

Background and Purpose

• Sinus osteotomy is a common surgical procedure in equine medicine to access the sinus cavities.
• Traditional tools like trephines and oscillating bone saws can cause trauma to bone and surrounding tissues.
• In human maxillofacial surgery, piezoelectric devices have become a standard due to their precision and reduced trauma, resulting in faster healing.
• The study aimed to test if piezoelectric devices could be effectively used for equine sinus surgery and compare outcomes to those achieved with oscillating saws.

Methods

• The study consisted of two parts: a cadaveric study and a clinical evaluation.
• Cadaveric Study:
  • 10 horse cadaver heads were used.
  • Each head underwent a frontonasal bone flap created on one side with the piezoelectric device (piezotome) and on the opposite side using the oscillating bone saw.
  • Surgical time for each method was recorded.
  • A gross examination post-procedure was conducted to assess the bone and soft tissue condition.
  • Statistical comparison of surgical times was done using a Welch t test.
• Clinical Study:
  • 11 client-owned horses presenting for sinonasal surgery at a hospital from March through October 2023.
  • The piezoelectric device was used to perform the osteotomies for their clinical treatment.
  • Outcomes and complications were monitored and recorded.

Results

• Cadaveric Study:
  • The piezoelectric device successfully completed osteotomies in all specimens.
  • Surgical time was significantly longer with the piezotome compared to the oscillating bone saw (statistically significant with P < .05).
  • Gross examination suggested better preservation of soft tissues around the osteotomy with the piezoelectric device.
• Clinical Study:
  • All clinical patients were successfully treated using the piezoelectric device.
  • No adverse effects or long-term complications directly related to the use of the piezotome were reported.
  • Soft tissue preservation was observed, indicating less surgical trauma.

Conclusions

• The piezoelectric device is a feasible tool for sinus osteotomy in horses and offers advantages in terms of preserving soft tissues.
• One limitation is the increased surgical time required when using the piezotome compared to traditional oscillating saws, as shown by the cadaveric study.
• The technology may enhance clinical outcomes by reducing trauma and potentially aiding healing, although efficiency during surgery is somewhat reduced.
• Further considerations might include weighing the benefit of less tissue trauma against longer operating times in clinical decision-making.