A pilot study evaluating the usage of the ultrasound aspirator Sonopet in transnasal skull base surgery

Introduction:

Ultrasound aspirators are commonly employed for careful tissue resections in open, transcranial neurosurgery. They are not routinely used in transnasal skull base surgery.

Methods:

In this feasibility trial, the Sonopet ultrasound aspirator (Stryker Corporation, Kalamazoo, MI, USA) was used in conjunction with extra-long tips for the ablation of hard (“Spetzler Superlong Micro Claw“, “Spetzler Superlong Open Angle Micro Claw” and ”Payner Superlong 360”) as well as soft tissue („Superlong Straight“) in a total of 10 patients that underwent transnasal surgery of various pathologies of the skull base. Results were evaluated qualitatively and with a standardized questionnaire.

Results:

The dimensions of the used tips allowed for a good range of movement of the instruments under endoscopic control, and the length was adequate to address pathologies back to the clivus. As angulated tips were not available, the range of movement was restricted to lesions not far off the midline. The instrument was far more effective in the ablation of soft tissue in comparison to cartilaginous/bony tissue. Natural barriers such as the dura were respected well by the aspirator, helping to selectively debride diseased tissue in sensitive areas.

Conclusions:

Using extra-long tips, the „Sonopet“ ultrasound aspirator seems well suited for an application in transnasal skull base surgery. It might serve as a useful supplement to cold steel instruments and powered instrumentation such as burrs and microdebriders, but its exact role needs to be defined in larger trials.

Publication History

Publication Date:
18 April 2018 (online)