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

PURPOSE: To compare the results of scanning electron microscopy studies of the surface of bone fragments of orbital lateral wall formed by mechanical and ultrasonic bone removal devices. MATERIAL AND METHODS: The surfaces of 7 bone fragments have been investigated after bony orbital decompression in patients with thyroid eye disease (TED). Electron microscopy of the bone relief was performed after exposure to an ultrasonic surgical system or a high-speed drill. RESULTS: Electron microscopy revealed that relief of the bony surface within a compact substance after application of an ultrasonic aspirator had parallel grooves of the same type up to 100 μm in depth and 80-100 μm wide, with relatively smooth edges. In the area of impact on spongy substance the bone surface became more amorphous, rougher due to the exposure of cellular structures at different depths. High-speed drill used in the area of compact substance left monotonous, almost flat relief with individual compact conglomerates of bone 'dust'. Removal of thinned fragments of the compact substance of the specimen led to appearance of the cellular structure typical for a spongy substance. CONCLUSION: Data on features of the relief of the edges of bone 'window' obtained for the first time, as well as specifics of working in conditions of limited surgical access allowed the conclusion that modern ultrasonic bone aspiration is promising for deep lateral wall decompression and some other orbital interventions.