Robotic cochlear implantation: surgical procedure and first clinical experience.

Caversaccio M; Gavaghan K; Wimmer W; Williamson T; Ansò J; Mantokoudis G; Gerber N; Rathgeb C; Feldmann A; Wagner F; Scheidegger O; Kompis M; Weisstanner C; Zoka-Assadi M; Roesler K; Anschuetz L; Huth M; Weber S

doi:10.1080/00016489.2017.1278573

Back

Journal article

Robotic cochlear implantation: surgical procedure and first clinical experience.

Caversaccio M a Department of ENT, Head and Neck Surgery , Inselspital, Bern University Hospital, University of Bern , Bern , Switzerland.
Gavaghan K b Image-Guided Therapy and Artificial Hearing Research, ARTORG Center for Biomedical Engineering Research , University of Bern , Bern , Switzerland.
Wimmer W a Department of ENT, Head and Neck Surgery , Inselspital, Bern University Hospital, University of Bern , Bern , Switzerland.
Williamson T b Image-Guided Therapy and Artificial Hearing Research, ARTORG Center for Biomedical Engineering Research , University of Bern , Bern , Switzerland.
Ansò J b Image-Guided Therapy and Artificial Hearing Research, ARTORG Center for Biomedical Engineering Research , University of Bern , Bern , Switzerland.
Mantokoudis G a Department of ENT, Head and Neck Surgery , Inselspital, Bern University Hospital, University of Bern , Bern , Switzerland.
Gerber N b Image-Guided Therapy and Artificial Hearing Research, ARTORG Center for Biomedical Engineering Research , University of Bern , Bern , Switzerland.
Rathgeb C b Image-Guided Therapy and Artificial Hearing Research, ARTORG Center for Biomedical Engineering Research , University of Bern , Bern , Switzerland.
Feldmann A c Musculoskeletal Biomechanics, Institute for Surgical Technologies and Biomechanics, University of Bern , Bern , Switzerland.
Wagner F d University Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital , Bern , Switzerland.
Scheidegger O e Department of Neurology , Inselspital, University of Bern , Bern , Switzerland.
Kompis M a Department of ENT, Head and Neck Surgery , Inselspital, Bern University Hospital, University of Bern , Bern , Switzerland.
Weisstanner C d University Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital , Bern , Switzerland.
Zoka-Assadi M f MED-EL Medical Electronics , Innsbruck , Austria.
Roesler K e Department of Neurology , Inselspital, University of Bern , Bern , Switzerland.
Anschuetz L a Department of ENT, Head and Neck Surgery , Inselspital, Bern University Hospital, University of Bern , Bern , Switzerland.
Huth M a Department of ENT, Head and Neck Surgery , Inselspital, Bern University Hospital, University of Bern , Bern , Switzerland.
Weber S b Image-Guided Therapy and Artificial Hearing Research, ARTORG Center for Biomedical Engineering Research , University of Bern , Bern , Switzerland.

2017-02-02

Published in:

Acta oto-laryngologica. - 2017

English CONCLUSION
A system for robotic cochlear implantation (rCI) has been developed and a corresponding surgical workflow has been described. The clinical feasibility was demonstrated through the conduction of a safe and effective rCI procedure.

OBJECTIVES
To define a clinical workflow for rCI and demonstrate its feasibility, safety, and effectiveness within a clinical setting.

METHOD
A clinical workflow for use of a previously described image guided surgical robot system for rCI was developed. Based on pre-operative images, a safe drilling tunnel targeting the round window was planned and drilled by the robotic system. Intra-operatively the drill path was assessed using imaging and sensor-based data to confirm the proximity of the facial nerve. Electrode array insertion was manually achieved under microscope visualization. Electrode array placement, structure preservation, and the accuracy of the drilling and of the safety mechanisms were assessed on post-operative CT images.

RESULTS
Robotic drilling was conducted with an accuracy of 0.2 mm and safety mechanisms predicted proximity of the nerves to within 0.1 mm. The approach resulted in a minimal mastoidectomy and minimal incisions. Manual electrode array insertion was successfully performed through the robotically drilled tunnel. The procedure was performed without complications, and all surrounding structures were preserved.

Language