Demonstrator an sonodynamic ablative procedures

在项目的初始阶段（FOR 1585，多端口骨手术作为耳基MUKNO的示例），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。这些结果可以在人颞骨尸体模型上的仿真传输中得到验证。然而，在岩骨的较深部分中的进入路径的干扰以及操纵空间的设计（例如，在肿瘤的微创切除的情况下）仍然是有问题的。预计通过非线性途径将向前迈出重要一步，这些途径可以根据最短的途径进入感兴趣的区域，绕过关键区域。尽管MUKNO手术可行，但可能的钻孔轨迹的直径以及手术操作的目标区域相对于患者解剖结构的空间仍然有限。因此，在岩骨中实施微创手术的另一个条件也是适当的，即通过用于非线性通路的柔性器械来安全地操作，尽管在目的地处的处理空间有限。为此目的，需要其他仪器，特别是柔性微型仪器。此外，由于基于线缆引导应用的进入路径的线性缺失，必须使用组织调制的其他物理方法，例如，以生物学方式切除肿瘤或通过消融。声动力消融手术在医学上以压电外科的形式建立。超声波范围内的微振动产生并传递到切削刀具上。因此，它可以用作骨锯，同时保护软组织，因为该组织显示出不同的共振行为。到目前为止，没有组织选择性操纵软组织的超声是可能的。如果不同的细胞类型，如肿瘤细胞与健康粘膜细胞相比显示出不同的共振，则可以选择性消融特定的软组织。将声动力学施加器与肿瘤连接，通过特定频率的超声波对其进行刺激，并在周围健康软组织的保护下破坏细胞特异性结合，这将是可能的。本项目的进一步建议是总结项目1至5，并在人体颅骨制备的基础上在演示器中进行评估。在干预期间和之后，将对非线性轨迹的规划和控制的所有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.