Prospective Validation of Facial Nerve Monitoring to Prevent Nerve Damage During Robotic Drilling

Anso, Juan; Dür, Cilgia; Apelt, Mareike; Venail, Frederic; Scheidegger, Oliver; Seidel, Kathleen; Rohrbach, Helene; Forterre, Franck; Dettmer, Matthias S.; Zlobec, Inti; Weber, Klaus; Matulic, Marco; Zoka-Assadi, Masoud; Huth, Markus; Caversaccio, Marco; Weber, Stefan (2019). Prospective Validation of Facial Nerve Monitoring to Prevent Nerve Damage During Robotic Drilling. Frontiers in Surgery, 6(58) Frontiers 10.3389/fsurg.2019.00058

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Facial nerve damage has a detrimental effect on a patient's life, therefore safety mechanisms to ensure its preservation are essential during lateral skull base surgery. During robotic cochlear implantation a trajectory passing the facial nerve at <0.5 mm is needed. Recently a stimulation probe and nerve monitoring approach were developed and introduced clinically, however for patient safety no trajectory was drilled closer than 0.4 mm. Here we assess the performance of the nerve monitoring system at closer distances. In a sheep model eight trajectories were drilled to test the setup followed by 12 trajectories during which the ENT surgeon relied solely on the nerve monitoring system and aborted the robotic drilling process if intraoperative nerve monitoring alerted of a distance <0.1 mm. Microcomputed tomography images and histopathology showed prospective use of the technology prevented facial nerve damage. Facial nerve monitoring integrated in a robotic system supports the surgeon's ability to proactively avoid damage to the facial nerve during robotic drilling in the mastoid.

Item Type:

Journal Article (Original Article)

Division/Institute:

05 Veterinary Medicine > Department of Clinical Veterinary Medicine (DKV) > Small Animal Clinic
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 > Service Sector > Institute of Pathology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy
04 Faculty of Medicine > Service Sector > Institute of Pathology > Translational Research Unit

UniBE Contributor:

Anso, Juan; Dür, Cilgia; Apelt, Mareike; Scheidegger, Oliver; Seidel, Kathleen; Rohrbach, Helene; Forterre, Franck; Dettmer, Matthias; Zlobec, Inti; Huth, Markus; Caversaccio, Marco and Weber, Stefan

Subjects:

600 Technology > 630 Agriculture
600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology
600 Technology > 620 Engineering

ISSN:

2296-875X

Publisher:

Frontiers

Language:

English

Submitter:

Juan Anso

Date Deposited:

08 Oct 2019 10:04

Last Modified:

23 Oct 2019 18:25

Publisher DOI:

10.3389/fsurg.2019.00058

BORIS DOI:

10.7892/boris.133736

URI:

https://boris.unibe.ch/id/eprint/133736

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