Details
| Original language | English |
|---|---|
| Pages (from-to) | 475-486 |
| Number of pages | 12 |
| Journal | International journal of computer assisted radiology and surgery |
| Volume | 4 |
| Issue number | 5 |
| Publication status | Published - 2009 |
Abstract
Purpose: The aim of this study was to create an access canal to the inner ear, by drilling, and perform the cochleostomy for cochlear implant surgery using robot guidance. Methods: A robot, a surgical drill and an Image-Guided Surgery (IGS) system were combined in a closed-loop setup. Ten temporal bones were scanned at the planning stages of the procedure. The robot guided the drill along the preplanned trajectory and created the approach. Postoperative scans were obtained. Results: The cochleostomy was performed completely in nine out of ten cases. This did not prove possible for one of the specimens, the target site selected being in too superficial a location in relation to the round window. No violation of the facial nerve took place, although the chorda tympani nerve was violated in one case and the stapes in two. It was obvious during preoperative planning that these structures would be violated, but this was accepted in order to maintain a safety margin from the facial nerve. No other unforeseen damage occurred. Conclusions: This preliminary study suggests that robot-guided drilling of a minimally invasive approach to the cochlea might be feasible, but further improvements are necessary before any clinical application becomes possible. Where the width of the facial recess is less than 2.5 mm, the chorda tympani nerve and the ossicles are at risk.
Keywords
- Cochlear implant surgery, Image-guided surgery, Minimally invasive approach, Robot-assisted surgery, Robot-guided surgery
ASJC Scopus subject areas
- Medicine(all)
- Surgery
- Engineering(all)
- Biomedical Engineering
- Medicine(all)
- Radiology Nuclear Medicine and imaging
- Computer Science(all)
- Computer Vision and Pattern Recognition
- Medicine(all)
- Health Informatics
- Computer Science(all)
- Computer Science Applications
- Computer Science(all)
- Computer Graphics and Computer-Aided Design
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In: International journal of computer assisted radiology and surgery, Vol. 4, No. 5, 2009, p. 475-486.
Research output: Contribution to journal › Article › Research › peer review
}
TY - JOUR
T1 - A robot-guided minimally invasive approach for cochlear implant surgery
T2 - Preliminary results of a temporal bone study
AU - Majdani, Omid
AU - Rau, Thomas S.
AU - Baron, Stephan
AU - Eilers, Hubertus
AU - Baier, Claas
AU - Heimann, Bodo
AU - Ortmaier, Tobias
AU - Bartling, Sönke
AU - Lenarz, Thomas
AU - Leinung, Martin
N1 - Funding information: Source of financial support or funding: Deutsche Forschungsgemeinschaft (DFG-German Research Foundation), Priority Program 1124 (Medical Robotics).
PY - 2009
Y1 - 2009
N2 - Purpose: The aim of this study was to create an access canal to the inner ear, by drilling, and perform the cochleostomy for cochlear implant surgery using robot guidance. Methods: A robot, a surgical drill and an Image-Guided Surgery (IGS) system were combined in a closed-loop setup. Ten temporal bones were scanned at the planning stages of the procedure. The robot guided the drill along the preplanned trajectory and created the approach. Postoperative scans were obtained. Results: The cochleostomy was performed completely in nine out of ten cases. This did not prove possible for one of the specimens, the target site selected being in too superficial a location in relation to the round window. No violation of the facial nerve took place, although the chorda tympani nerve was violated in one case and the stapes in two. It was obvious during preoperative planning that these structures would be violated, but this was accepted in order to maintain a safety margin from the facial nerve. No other unforeseen damage occurred. Conclusions: This preliminary study suggests that robot-guided drilling of a minimally invasive approach to the cochlea might be feasible, but further improvements are necessary before any clinical application becomes possible. Where the width of the facial recess is less than 2.5 mm, the chorda tympani nerve and the ossicles are at risk.
AB - Purpose: The aim of this study was to create an access canal to the inner ear, by drilling, and perform the cochleostomy for cochlear implant surgery using robot guidance. Methods: A robot, a surgical drill and an Image-Guided Surgery (IGS) system were combined in a closed-loop setup. Ten temporal bones were scanned at the planning stages of the procedure. The robot guided the drill along the preplanned trajectory and created the approach. Postoperative scans were obtained. Results: The cochleostomy was performed completely in nine out of ten cases. This did not prove possible for one of the specimens, the target site selected being in too superficial a location in relation to the round window. No violation of the facial nerve took place, although the chorda tympani nerve was violated in one case and the stapes in two. It was obvious during preoperative planning that these structures would be violated, but this was accepted in order to maintain a safety margin from the facial nerve. No other unforeseen damage occurred. Conclusions: This preliminary study suggests that robot-guided drilling of a minimally invasive approach to the cochlea might be feasible, but further improvements are necessary before any clinical application becomes possible. Where the width of the facial recess is less than 2.5 mm, the chorda tympani nerve and the ossicles are at risk.
KW - Cochlear implant surgery
KW - Image-guided surgery
KW - Minimally invasive approach
KW - Robot-assisted surgery
KW - Robot-guided surgery
UR - http://www.scopus.com/inward/record.url?scp=68549139903&partnerID=8YFLogxK
U2 - 10.1007/s11548-009-0360-8
DO - 10.1007/s11548-009-0360-8
M3 - Article
C2 - 20033531
AN - SCOPUS:68549139903
VL - 4
SP - 475
EP - 486
JO - International journal of computer assisted radiology and surgery
JF - International journal of computer assisted radiology and surgery
SN - 1861-6410
IS - 5
ER -