Purpose: This paper illustrates the use of ultrasonic bone cutting combined with endoscopy for all of the osteotomies in surgically assisted rapid maxillary expansion (SARME), which we renamed ultrasound endoscopic rapid maxillary expansion (UERME).

Materials and methods: Between 2012 and 2013, we treated 8 patients affected by transversal discrepancy of maxilla, using this ultrasound endoscopic approach. The endoscope used was a rigid 2.7-mm-diameter, 30° scope connected to a video system comprising a camera, light source, and monitor (all from Karl Storz, Germany). We used the Piezosurgery device (Mectron, Carasco, Italy) with new surgical tips. Three vertical incisions are made into the soft mucosa in the premolar area: one central (interincisal) and two lateral. Blind tunnellisation is performed using a single elevator from the central incision towards the zygomatic buttresses bilaterally, and then from the zygomatic buttresses to the pterygomaxillary junction. With endoscopic assistance, we perfomed all osteotomies.

Results: The procedure is less invasive, using three small vertical incisions and a tunnelling approach to reach the maxilla. Technical and clinical considerations: direct vision; precise, safe osteotomy control; minimal bleeding risk; and reduced dissection and consequent postoperative oedema and swelling.

Conclusions: UERME rapresent a really interesting a promising minimally invasive surgery for SARME.

Conflict of interest: No conflict of interest.

Key words: piezosurgery; ultrasound; endoscopic; SARME