Robotic Cochlear Implantation: First Clinical Results

Wimmer, Wilhelm; Weber, Stefan; Anso, Juan; Gerber, Kate; Gerber, Nicolas; Huth, Markus; Mantokoudis, Georgios; Kompis, Martin; Caversaccio, Marco (27 July 2017). Robotic Cochlear Implantation: First Clinical Results (Unpublished). In: 15th Symposium on Cochlear Implants in Children. San Francisco. 26. - 29. Juli 2017.

Introduction: Robotic cochlear implantation is a new minimally invasive approach for CI surgery. The procedure is currently evaluated in a clinical trial at the Inselspital in Bern, Switzerland. The aim of this presentation is to report preliminary clinical results of the first cases of robotic cochlear implantation. Methods: The clinical study was approved by the local IRB and regulatory body. Preoperative assessments included morphological evaluation using CT, taste examination and facial nerve neurography. During surgery, four bone fiducial screws were inserted behind the ear and CT (0.2 mm resolution) was performed to plan a drill trajectory from the mastoid surface, passing through the facial recess to the center of the round window. Access to the middle ear was drilled using a previously developed task specific image-guided robotic system. Sufficient clearance of the drill trajectory from the facial nerve was confirmed using intraoperative cone beam CT imaging. Upon completion of drilling and screw removal, a tympanomeatal flap was created and the round window membrane was exposed. An implant bed was prepared and the electrode array was manually inserted using a specifically manufactured insertion tube. Correct placement and nominal function of the implant was verified by telemetry and postoperative CT imaging. Postoperative facial nerve neurography and taste examination took place two weeks postoperatively. Audiological assessment was performed as part of routine clinical care. Results: Robotic middle ear access was completed in 4 patients, with successful electrode insertion according to the preoperatively defined plan. Audiological results for all patients are currently being collected. Conclusions: We have demonstrated in 4 patients that a CI electrode can be successfully inserted into the cochlea through a 1.8 mm keyhole access created by a surgical robot. The workflow with the robotic setup requires additional setup time and extensive teamwork.

Item Type:

Conference or Workshop Item (Poster)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy > ARTORG Center - Artificial Hearing Research
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy

UniBE Contributor:

Wimmer, Wilhelm; Weber, Stefan; Anso, Juan; Gerber, Kate; Gerber, Nicolas; Huth, Markus; Mantokoudis, Georgios; Kompis, Martin and Caversaccio, Marco

Subjects:

600 Technology > 610 Medicine & health

Language:

English

Submitter:

Wilhelm Wimmer

Date Deposited:

03 Nov 2017 14:12

Last Modified:

03 Nov 2017 14:12

URI:

https://boris.unibe.ch/id/eprint/106324

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