Pre-operative Screening and Manual Drilling Strategies to Reduce the Risk of Thermal Injury During Minimally Invasive Cochlear Implantation Surgery.
Pre-operative Screening and Manual Drilling Strategies to Reduce the Risk of Thermal Injury During Minimally Invasive Cochlear Implantation Surgery.
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DOI：
10.1007/s10439-017-1854-0
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发表时间：
2017-09
影响因子：
3.8
通讯作者：
Labadie RF
中科院分区：
文献类型：
--
作者：
Dillon NP;Fichera L;Kesler K;Zuniga MG;Mitchell JE;Webster RJ 3rd;Labadie RF
本文介绍了一种方法的发展和实验验证，以减少在微创人工耳蜗术中面神经热损伤的风险。这一方法的第一步是术前筛查过程，在这一过程中，医学成像被用来识别那些在手术的钻探阶段出现面神经高温的显著风险的患者。这样的风险是基于沿钻孔路径的骨密度以及钻孔路径与神经之间的热导来计算的，并提供了排除高危患者接受微创手术的标准。该方法的第二个组成部分是在面神经附近进行手动引导钻探的钻探策略。该战略利用间隔钻进和机械约束，以实现对过程和由此产生的热量的更好控制。该方法在新鲜身体的颞骨上进行了测试，使用热像仪监测面神经附近的温度。结果表明，术前筛查可以成功地排除高危患者，所提出的钻探策略能够为低到中等风险的患者提供安全的钻探。
This article presents the development and experimental validation of a methodology to reduce the risk of thermal injury to the facial nerve during minimally invasive cochlear implantation surgery. The first step in this methodology is a pre-operative screening process, in which medical imaging is used to identify those patients that present a significant risk of developing high temperatures at the facial nerve during the drilling phase of the procedure. Such a risk is calculated based on the density of the bone along the drilling path and the thermal conductance between the drilling path and the nerve, and provides a criterion to exclude high-risk patients from receiving the minimally invasive procedure. The second component of the methodology is a drilling strategy for manually-guided drilling near the facial nerve. The strategy utilizes interval drilling and mechanical constraints to enable better control over the procedure and the resulting generation of heat. The approach is tested in fresh cadaver temporal bones using a thermal camera to monitor temperature near the facial nerve. Results indicate that pre-operative screening may successfully exclude high-risk patients and that the proposed drilling strategy enables safe drilling for low-to-moderate risk patients.
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影响因子：
2.2
作者：
Davidson, SRH;James, DF
通讯作者：
James, DF
影响因子：
3
作者：
DEVRIND, HH;WONDERGEM, J;HAVEMAN, J
通讯作者：
HAVEMAN, J
影响因子：
2.1
作者：
Anso, Juan;Duer, Cilgia;Weber, Stefan
通讯作者：
Weber, Stefan
用于经皮的耳蜗植入的骨骼和平行机器人的设计。
DOI：
10.1109/tbme.2011.2162512
发表时间：
2011-10
期刊：
IEEE transactions on bio-medical engineering
影响因子：
--
作者：
Kratchman LB;Blachon GS;Withrow TJ;Balachandran R;Labadie RF;Webster RJ 3rd
通讯作者：
Webster RJ 3rd
影响因子：
1.4
作者：
Bell, Brett;Stieger, Christof;Weber, Stefan
通讯作者：
Weber, Stefan