Demonstrator an sonodynamic ablative procedures

在项目的初始阶段(以1585年为例，多端口骨科手术为OtoBasis MUKNO)，通过优化耳基内不同感兴趣区域的成像、配准和风险评估，开发了基于软件的多端口方法的规划和模拟。这些结果可以在一个人的颞骨身体模型上的仿真传输中得到验证。然而，岩骨更深部分的通路的干扰，以及操作空间的设计，例如在微创切除肿瘤的情况下，仍然存在问题。预计将通过可绕过关键区域的非线性路径向前迈出重要的一步，根据对感兴趣区域的最短通道。尽管MUKNO手术是可行的，但可能的钻孔轨迹的直径，以及与患者解剖相关的手术操作靶区的空间仍然有限。因此，在岩骨实施微创手术的进一步条件也是适当的，通过灵活的器械使非线性通路在目的地处理空间有限的情况下仍能安全地操作。为此目的还需要其他的，特别是灵活的微型仪器。此外，由于在电缆引导应用的基础上缺少访问路径的线性，因此必须使用组织调制的其他物理方法，例如，以生物方式或通过消融来灭活肿瘤。声动力消融手术在医学上是以压电外科的形式建立起来的。在超声范围内产生微振动，并在刀具上传输。因此，它可以作为骨骼的锯子，同时保护软组织，因为这些组织表现出不同的共振行为。到目前为止，还不可能通过超声波对软组织进行组织选择性操作。如果与健康粘膜细胞相比，不同类型的细胞，如肿瘤细胞，表现出不同的共振，选择性地消融特定的软组织将是可能的。将声动力敷贴器连接到肿瘤上，用特定频率的超声波刺激它，并在保护周围健康软组织的情况下打破细胞特异性结合是可能的。本项目的进一步建议是总结项目1至5，并在演示设备中以人类头骨标本为基础进行评估。将对干预期间和干预后的非线性弹道规划和控制的各个部分进行监测和计量分析。

In the initial phase of the project (FOR 1585, multi-port bone surgery as example of the otobasis MUKNO) a software-based planning and simulation of the multi-port approaches was developed by optimization of imaging, registration and risk assessment to different regions of interest within the otobasis. These results could be validated in the transmission of the simulation on a human temporal bone cadaver model. However, an interference of the access routes in deeper parts of the petrous bone, as well as the design of the manipulation space, e.g. in case of a minimally invasive resection of tumors remain problematic. A significant step forward is expected through non-linear pathways which could bypass critical regions in accordance with shortest access to the region of interest. The diameter of the possible drilling trajectory, as well as the space at the target area for the surgical manipulation in relation to the patients anatomy remains limited despite the feasibility of a MUKNO procedure. Therefore, a further condition for the implementation of a minimally invasive surgery in the petrous bone is also appropriate by flexible instruments for the non-linear access to operate safely despite a limited handling space at the destination. Other, in particular flexible microinstruments are required for this purpose. In addition, other physical methods of tissue modulation must be used because of missing linearity of the access routes on the basis of cable-guided applications, for example, to inactivate tumor biologically or by ablation. Sonodynamic ablation procedures are established in medicine in the form of piezosurgery. Micro-vibrations in the ultrasonic range are generated and transmitted on a cutting tool. It can thus serve as a saw for bone while it protects soft tissue at the same time, because this tissue shows a different resonance behavior. So far, no tissue-selective manipulation of soft tissue by ultrasound is possible. If different cell types such as tumor cells compared to healthy mucosa cells show a different resonance, a selective ablation of specific soft tissue will be possible. It would be possible to connect a sonodynamic applicator with a tumor, stimulate it by a specific frequency of the ultrasonic, and break cell-specific bindings under protection of the healthy surrounding soft tissue.The further propose of this project is to summarizes the projects 1 to 5 and evaluated in a demonstrator on the basis of human skull preparations. All parts of the planning and control of non-linear trajectory during and after the intervention will be monitored and metrologically analyzed.