Orbital trapdoor fractures are characterized by tissue entrapment between the fractured bone fragment and the remnant of the orbital floor. This entrapment can result in immediate local and systemic complications and poor outcomes when approached late. This article presents the case of an orbital floor fracture in a child with dystopia, pain, edema and entrapment of the inferior rectus muscle and consequent limitation of ocular motility. The strategy proposed in the early approach to orbital floor reconstruction and release of incarcerated tissue allowed the patient to achieve satisfactory results without morbidity, as compared to the outcomes of corrective sequel surgery.

Osteoma is the most frequent benign tumor in the craniomaxillofacial region. The most common initial manifestation is facial pressure or headache. The clinical examination showed increased volume in the right supraorbital region, asymmetry of the orbital contour, exophthalmia, dystopia, proptosis and clinical restraint of ocular movement for supraversion. The lesion measured approximately 4 cm in diameter with irregular contour. Osteotomy was performed with saw surrounding the tumor, with aid of a surgical piezo on the orbital medial wall. The result of histopathological examination was osteoma. The patient is 2.5 years postoperatively and so far without complications.

Introduction: The principle of piezosurgery is electrification by pressure. When electrical voltage is applied to certain materials, such as quartz and Rochelle salts, it causes the materials to expand and contract, producing ultrasonic vibrations. This device uses ultrasonic vibrations of 60-210μm/s at 24-36kHz to selectively remove bone, with minimal damage to soft tissue such as blood vessels and nerves. It also provides excellent visibility due to its cavitation effect. Piezosurgery uses low-frequency ultrasonic vibration for osteotomies, minimizing the risk of damage to soft tissues (nerves, vessels and mucosa). Micrometric vibration ensures precise cutting action and allows operational control, increasing safety in anatomical areas that are difficult to access. Objective: The objective of this article is to present an ultrasonic tip geometry capable of providing a smaller contact area, less effort, reduced heat generation, faster cutting and shorter surgical time.

The principle of piezosurgery is “pressure electrification”. When electrical voltage is applied to certain materials such as quartz and Rochelle salts, it causes the materials to expand and contract, producing ultrasonic vibrations. This device uses ultrasonic vibration at 60–210 μm/s at 24–36 kHz to selectively remove bone with minimal damage to soft tissues such as blood vessels and nerves. In addition, it provides excellent visibility due to its cavitation effect. Piezoelectric surgery uses low-frequency ultrasonic vibration for osteotomy, which minimizes the risk of damage to soft tissue (nerves, vessels and mucosa). Micrometric vibration ensures precise cutting action and allows operative control, with consequent increased safety, in anatomical areas that are difficult to access. The aim of this study is to provide a device capable of providing a smaller contact area, less effort, lower temperature generation, faster cutting, shorter surgery time, shorter post-operative time and maxillofacial, orthopedic, neurosurgical and otorhinolaryngological procedures.