A robot-guided minimally invasive approach for cochlear implant surgery: preliminary results of a temporal bone study
A robot-guided minimally invasive approach for cochlear implant surgery: preliminary results of a temporal bone study
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DOI：
10.1007/s11548-009-0360-8
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发表时间：
2009-09-01
影响因子：
3
通讯作者：
Leinung, Martin
中科院分区：
文献类型：
--
作者：
Majdani, Omid;Rau, Thomas S.;Leinung, Martin
Purpose-本研究的目的是创建一个进入内耳的通道，通过钻孔，并使用机器人guidance.Methods进行人工耳蜗植入手术的耳蜗造口术机器人，手术钻和图像引导手术（IGS）系统相结合的闭环设置。在手术计划阶段扫描了10块颞骨。机器人引导钻头沿着预先计划的轨迹并创建方法。结果10例患者中9例耳蜗完全吻合。这对于其中一个样本来说是不可能的，选择的靶部位相对于圆窗位置太浅。没有侵犯面神经发生，虽然鼓索神经被侵犯在一个案件和镫骨在两个。在术前计划中，这些结构显然会受到侵犯，但为了保持面神经的安全边界，这是可以接受的。没有其他不可预见的damage occurred.Conclusions这一初步研究表明，机器人引导钻孔的微创方法耳蜗可能是可行的，但进一步的改进是必要的，任何临床应用成为可能之前。面神经隐窝宽度小于2.5 mm时，鼓索神经和听小骨存在危险。
Purpose The aim of this study was to create an access canal to the inner ear, by drilling, and perform the cochleostomy for cochlear implant surgery using robot guidance.Methods A robot, a surgical drill and an Image-Guided Surgery (IGS) system were combined in a closed-loop setup. Ten temporal bones were scanned at the planning stages of the procedure. The robot guided the drill along the preplanned trajectory and created the approach. Postoperative scans were obtained.Results The cochleostomy was performed completely in nine out of ten cases. This did not prove possible for one of the specimens, the target site selected being in too superficial a location in relation to the round window. No violation of the facial nerve took place, although the chorda tympani nerve was violated in one case and the stapes in two. It was obvious during preoperative planning that these structures would be violated, but this was accepted in order to maintain a safety margin from the facial nerve. No other unforeseen damage occurred.Conclusions This preliminary study suggests that robot-guided drilling of a minimally invasive approach to the cochlea might be feasible, but further improvements are necessary before any clinical application becomes possible. Where the width of the facial recess is less than 2.5 mm, the chorda tympani nerve and the ossicles are at risk.