Robotic cochlear implantation: feasibility of a multiport approach in an ex vivo model.

Schneider, Daniel; Stenin, Igor; Ansó, Juan; Hermann, Jan; Müller, Fabian; Pereira Bom Braga, Gabriela; Rathgeb, Christoph; Wimmer, Wilhelm; Schipper, Joerg; Kristin, Julia; Caversaccio, Marco; Anschütz, Lukas; Weber, Stefan; Klenzner, Thomas (2019). Robotic cochlear implantation: feasibility of a multiport approach in an ex vivo model. European archives of oto-rhino-laryngology, 276(5), pp. 1283-1289. Springer 10.1007/s00405-019-05318-7

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PURPOSE A recent clinical trial has shown the feasibility of robotic cochlear implantation. The electrode was inserted through the robotically drilled tunnel and an additional access through the external auditory canal was created to provide for means of visualization and manipulation. To obviate the need for this additional access, the utilization of multiple robotically drilled tunnels targeting the round window has been proposed. The objective of this study was to assess the feasibility of electrode insertion through a robotic multiport approach. METHODS In four ex vivo human head specimens (left side), four trajectories through the facial recess (2x) and the retrofacial and suprameatal region were planned and robotically drilled. Optimal three-port configurations were determined for each specimen by analyzing combinations of three of the four trajectories, where the three trajectories were used for the electrode, endoscopic visualization and manipulative assistance. Finally, electrode insertions were conducted through the optimal configurations. RESULTS The electrodes could successfully be inserted, and the procedure sufficiently visualized through the facial recess drill tunnels in all specimens. Effective manipulative assistance for sealing the round window could be provided through the retrofacial tunnel. CONCLUSIONS Electrode insertion through a robotic three-port approach is feasible. Drill tunnels through the facial recess for the electrode and endoscope allow for optimized insertion angles and sufficient visualization. Through a retrofacial tunnel effective manipulation for sealing is possible.

Item Type:

Journal Article (Original Article)

Division/Institute:

10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy
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

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

Schneider, Daniel; Anso, Juan; Hermann, Jan; Müller, Fabian; Rathgeb, Christoph Martin; Wimmer, Wilhelm; Caversaccio, Marco; Anschütz, Lukas Peter and Weber, Stefan

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

0937-4477

Publisher:

Springer

Language:

English

Submitter:

Daniel Schneider

Date Deposited:

01 Nov 2019 15:02

Last Modified:

01 Nov 2019 15:02

Publisher DOI:

10.1007/s00405-019-05318-7

PubMed ID:

30739180

Uncontrolled Keywords:

Cochlear implantation Electrode insertion Multiport surgery Robotic surgery

BORIS DOI:

10.7892/boris.127194

URI:

https://boris.unibe.ch/id/eprint/127194

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