Robotic middle ear access for cochlear implantation: first in man

Caversaccio, Marco; Wimmer, Wilhelm; Anso, Juan; Mantokoudis, Georgios; Gerber, Nicolas; Rathgeb, Christoph Martin; Schneider, Daniel; Hermann, Jan; Wagner, Franca; Scheidegger, Olivier; Huth, Markus; Anschütz, Lukas Peter; Kompis, Martin; Williamson, Tom; Bell, Brett; Gerber, Kate; Weber, Stefan (2019). Robotic middle ear access for cochlear implantation: first in man. PLoS ONE, 14(8), e0220543. Public Library of Science 10.1101/19000711

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To demonstrate the feasibility of robotic middle ear access in a clinical setting, nine adult patients with severe-to-profound hearing loss indicated for cochlear implantation were included in this clinical trial. A keyhole access tunnel to the tympanic cavity and targeting the round window was planned based on preoperatively acquired computed tomography image data and robotically drilled to the level of the facial recess. Intraoperative imaging was performed to confirm sufficient distance of the drilling trajectory to relevant anatomy. Robotic drilling continued toward the round window. The cochlear access was manually created by the surgeon. Electrode arrays were inserted through the keyhole tunnel under microscopic supervision via a tympanomeatal flap. All patients were successfully implanted with a cochlear implant. In 9 of 9 patients the robotic drilling was planned and performed to the level of the facial recess. In 3 patients, the procedure was reverted to a conventional approach for safety reasons. No change in facial nerve function compared to baseline measurements was observed. Robotic keyhole access for cochlear implantation is feasible. Further improvements to workflow complexity, duration of surgery, and usability including safety assessments are required to enable wider adoption of the procedure.

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)
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy > ARTORG Center - Artificial Hearing Research

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

Caversaccio, Marco; Wimmer, Wilhelm; Anso, Juan; Mantokoudis, Georgios; Gerber, Nicolas; Rathgeb, Christoph Martin; Schneider, Daniel; Hermann, Jan; Wagner, Franca; Scheidegger, Olivier; Huth, Markus; Anschütz, Lukas Peter; Kompis, Martin; Williamson, Tom; Bell, Brett; Gerber, Kate and Weber, Stefan

Subjects:

600 Technology > 610 Medicine & health
600 Technology > 620 Engineering

ISSN:

1932-6203

Publisher:

Public Library of Science

Language:

English

Submitter:

Wilhelm Wimmer

Date Deposited:

26 Aug 2019 10:32

Last Modified:

03 Nov 2019 02:40

Publisher DOI:

10.1101/19000711

PubMed ID:

31374092

BORIS DOI:

10.7892/boris.131894

URI:

https://boris.unibe.ch/id/eprint/131894

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