- Composed of an
- Ultrasound generator,
- Sucker
- Irrigator
- Function
- Dissector
- Aspirator
- Selective for tissue with high water and low collagen content.
- Advantages
- Comprising fragmentation of solid tissues
- Relative sparing of vessels
- Reduction of surgical time
- By combining aspiration, ultrasonic dissection, and irrigation in a single operation
- Improved safety (by adjusting settings
- Supposed minimal trauma to surrounding neural brain structures.
- Disadvantages (Related to the inadequate and unknown control of its energy)
- Lead to sudden and sometimes unexpected events (vascular injuries and/or neural tissue damages)
- Possible interaction with intraoperative brain mapping.
- Motor testing performed through direct electrical stimulation a positive response is given by the active movement (or by its recording),
- CUSA use negatively interferes with electrical conduction in adjacent tissue it could lead to the misdetection of a motor site, reducing the sensitivity of the technique (if CUSA and DES are used simultaneously) by causing false-negative results and increasing the risk of motor deficit.
- Language testing a positive response is actually a negative event (e.g. inability to name objects).
- CUSA is used during intraoperative language testing, through its negative interference with neurological function it could show true-positive eloquent sites.
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