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.
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.
Authors: Daniel Schneider; Igor Stenin; Juan Ansó; Jan Hermann; Fabian Mueller; Gabriela Pereira Bom Braga; Christoph Rathgeb; Wilhelm Wimmer; Joerg Schipper; Julia Kristin; Marco Caversaccio; Lukas Anschuetz; Stefan Weber; Thomas Klenzner Journal: Eur Arch Otorhinolaryngol Date: 2019-02-09 Impact factor: 2.503
Authors: William G Morrel; Asitha D L Jayawardena; Susan M Amberg; Benoit M Dawant; Jack H Noble; Robert F Labadie Journal: Laryngoscope Date: 2018-12-24 Impact factor: 3.325
Authors: Christoph Rathgeb; Lukas Anschuetz; Daniel Schneider; Cilgia Dür; Marco Caversaccio; Stefan Weber; Tom Williamson Journal: Eur Arch Otorhinolaryngol Date: 2018-02-13 Impact factor: 2.503
Authors: Ahmet M Tekin; Marco Matulic; Wim Wuyts; Masoud Zoka Assadi; Griet Mertens; Vincent van Rompaey; Yongxin Li; Paul van de Heyning; Vedat Topsakal Journal: Genes (Basel) Date: 2021-04-21 Impact factor: 4.096
Authors: Andy S Ding; Sarah Capostagno; Christopher R Razavi; Zhaoshuo Li; Russell H Taylor; John P Carey; Francis X Creighton Journal: Otol Neurotol Date: 2021-12-01 Impact factor: 2.619
Authors: Katherine E Riojas; Emily T Tran; Michael H Freeman; Jack H Noble; Robert J Webster; Robert F Labadie Journal: J Med Device Date: 2021-04-02 Impact factor: 0.743