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Skull base surgery. 2000; 10(2): 71–74.
PMCID: PMC1656760

Use of the Ultrasonically Activated Scalpel in Acoustic Neuroma Surgery

Preliminary Report


Recently, the ultrasonic activated scalpel (the Harmonic Scalpel, HS) has been introduced in laparoscopic surgery. We have applied the HS in debulking the tumor in the posterior fossa and concluded that this is useful in acoustic neuroma surgery. Fifteen patients with a tumor extending more than 20 mm into the posterior fossa were included in this study. The extended middle cranial fossa approach type II was used in 13 patients and type III (hearing preservation surgery) was used in 2 patients. In one of two patients, hearing was preserved. Postroperative facial nerve function according to the House-Brackmann method was grade I in 12 patients, grade II in 2 patients, and grade III in 1 patient. Compating the technique of using HS to a pair of bipolar forceps and/or ultrasonic cavitational aspirator, the former can result in better preservation of the facial nerve function.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • McCarus SD. Physiologic mechanism of the ultrasonically activated scalpel. J Am Assoc Gynecol Laparosc. 1996 Aug;3(4):601–608. [PubMed]
  • Kanzaki J, Shiobara R, Toya S. Classification of the extended middle cranial fossa approach. Acta Otolaryngol Suppl. 1991;487:6–16. [PubMed]
  • Kemink JL, Langman AW, Niparko JK, Graham MD. Operative management of acoustic neuromas: the priority of neurologic function over complete resection. Otolaryngol Head Neck Surg. 1991 Jan;104(1):96–99. [PubMed]

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