Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-28T16:18:58.107Z Has data issue: false hasContentIssue false
  • English
  • Français

Development of an auditory implant manipulator for minimally invasive surgical insertion of implantable hearing devices

Published online by Cambridge University Press:  16 November 2010

C Stieger ,
M Caversaccio ,
A Arnold ,
G Zheng ,
J Salzmann ,
D Widmer ,
N Gerber ,
M Thurner ,
C Nauer  and
Y Mussard
...Show all authors
C Stieger
Affiliation:
ARTORG Center for Biomedical Engineering Research, University of Bern, Switzerland University Department of ENT, Head and Neck Surgery, Inselspital Bern, Switzerland
M Caversaccio*
Affiliation:
University Department of ENT, Head and Neck Surgery, Inselspital Bern, Switzerland
A Arnold
Affiliation:
University Department of ENT, Head and Neck Surgery, Inselspital Bern, Switzerland
G Zheng
Affiliation:
ARTORG Center for Biomedical Engineering Research, University of Bern, Switzerland
J Salzmann
Affiliation:
ARTORG Center for Biomedical Engineering Research, University of Bern, Switzerland
D Widmer
Affiliation:
ARTORG Center for Biomedical Engineering Research, University of Bern, Switzerland
N Gerber
Affiliation:
ARTORG Center for Biomedical Engineering Research, University of Bern, Switzerland
M Thurner
Affiliation:
Microrobotics Laboratory, University of Applied Science, Biel, Switzerland
C Nauer
Affiliation:
Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Switzerland
Y Mussard
Affiliation:
Microrobotics Laboratory, University of Applied Science, Biel, Switzerland
M Kompis
Affiliation:
University Department of ENT, Head and Neck Surgery, Inselspital Bern, Switzerland
L P Nolte
Affiliation:
ARTORG Center for Biomedical Engineering Research, University of Bern, Switzerland
R Häusler
Affiliation:
University Department of ENT, Head and Neck Surgery, Inselspital Bern, Switzerland
S Weber
Affiliation:
ARTORG Center for Biomedical Engineering Research, University of Bern, Switzerland
*
Address for correspondence: Prof Dr Marco Caversaccio, Chairman, University Department of ENT, Head and Neck Surgery, Inselspital/University Bern, 3010 Bern, Switzerland Fax: + 41 31 632 88 08 E-mail: marco.caversaccio@insel.ch
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To present the auditory implant manipulator, a navigation-controlled mechanical and electronic system which enables minimally invasive (‘keyhole’) transmastoid access to the tympanic cavity.

Materials and methods:

The auditory implant manipulator is a miniaturised robotic system with five axes of movement and an integrated drill. It can be mounted on the operating table. We evaluated the surgical work field provided by the system, and the work sequence involved, using an anatomical whole head specimen.

Results:

The work field provided by the auditory implant manipulator is considerably greater than required for conventional mastoidectomy. The work sequence for a keyhole procedure included pre-operative planning, arrangement of equipment, the procedure itself and post-operative analysis.

Conclusion:

Although system improvements are necessary, our preliminary results indicate that the auditory implant manipulator has the potential to perform keyhole insertion of implantable hearing devices.

Keywords

RoboticsMinimally Invasive Surgical ProceduresImplantable Hearing SystemsCochlear ImplantsTemporal Bone
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 3 , March 2011 , pp. 262 - 270
Copyright
Copyright © JLO (1984) Limited 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Kronenberg, J, Migirov, L, Dagan, T. Suprameatal approach: new surgical approach for cochlear implantation. J Laryngol Otol 2001;115:283–5CrossRefGoogle ScholarPubMed
2Hausler, R. Cochlear implantation without mastoidectomy: the pericanal electrode insertion technique. Acta Otolaryngol 2002;122:715–19CrossRefGoogle ScholarPubMed
3Doshi, J, Youngs, R. Navigational systems in rhinology: should we all be using them? J Laryngol Otol 2007;121:818–21CrossRefGoogle Scholar
4Hepworth, EJ, Bucknor, M, Patel, A, Vaughan, WC. Nationwide survey on the use of image-guided functional endoscopic sinus surgery. Otolaryngol Head Neck Surg 2006;135:68–73CrossRefGoogle ScholarPubMed
5Tabaee, A, Hsu, AK, Shrime, MG, Rickert, S, Close, LG. Quality of life and complications following image-guided endoscopic sinus surgery. Otolaryngol Head Neck Surg 2006;135:76–80Google ScholarPubMed
6Caversaccio, M, Langlotz, F, Nolte, LP, Hausler, R. Impact of a self-developed planning and self-constructed navigation system on skull base surgery: 10 years experience. Acta Otolaryngol 2007;127:403–7CrossRefGoogle ScholarPubMed
7Brett, PN, Taylor, RP, Proops, D, Coulson, C, Reid, A, Griffiths, MV. A surgical robot for cochleostomy. Conf Proc IEEE Eng Med Biol Soc 2007;2007:1229–32Google ScholarPubMed
8Coulson, CJ, Reid, AP, Proops, DW, Brett, PN. ENT challenges at the small scale. Int J Med Robot 2007;3:91–6CrossRefGoogle ScholarPubMed
9Rothbaum, DL, Roy, J, Stoianovici, D, Berkelman, P, Hager, GD, Taylor, RH et al. Robot-assisted stapedotomy: micropick fenestration of the stapes footplate. Otolaryngol Head Neck Surg 2002;127:417–26CrossRefGoogle ScholarPubMed
10Majdani, O, Bartling, SH, Leinung, M, Stover, T, Lenarz, M, Dullin, C et al. A true minimally invasive approach for cochlear implantation: high accuracy in cranial base navigation through flat-panel-based volume computed tomography. Otol Neurotol 2008;29:120–3CrossRefGoogle ScholarPubMed
11Labadie, RF, Noble, JH, Dawant, BM, Balachandran, R, Majdani, O, Fitzpatrick, JM. Clinical validation of percutaneous cochlear implant surgery: initial report. Laryngoscope 2008;118:1031–9CrossRefGoogle ScholarPubMed
12Maassen, MM, Malthan, D, Stallkamp, J, Schafer, A, Dammann, F, Schwaderer, E et al. Laser-based quality assurance for robot-assisted milling at the base of the skull [in German]. HNO 2006;54:105–11CrossRefGoogle ScholarPubMed
13Klenzner, T, Ngan, CC, Knapp, FB, Knoop, H, Kromeier, J, Aschendorff, A et al. New strategies for high precision surgery of the temporal bone using a robotic approach for cochlear implantation. Eur Arch Otorhinolaryngol 2009;266:955–60CrossRefGoogle ScholarPubMed
14Federspil, PA, Geisthoff, UW, Henrich, D, Plinkert, PK. Development of the first force-controlled robot for otoneurosurgery. Laryngoscope 2003;113:465–71CrossRefGoogle ScholarPubMed
15Zheng, G, Caversaccio, M, Bachler, R, Langlotz, F, Nolte, LP, Hausler, R. Frameless optical computer-aided tracking of a microscope for otorhinology and skull base surgery. Arch Otolaryngol Head Neck Surg 2001;127:1233–8CrossRefGoogle ScholarPubMed
16Rudolph, T, Puls, M, Anderegg, C, Ebert, L, Broehan, M, Rudin, A et al. MARVIN: a medical research application framework based on open source software. Comput Methods Programs Biomed 2008;91:165–74CrossRefGoogle Scholar
17Nauer, CB, Eichenberger, A, Dubach, P, Gralla, J, Caversaccio, M. CT radiation dose for computer-assisted endoscopic sinus surgery: dose survey and determination of dose-reduction limits. AJNR Am J Neuroradiol 2009;30:617–22CrossRefGoogle ScholarPubMed
18Muren, C, Wadin, K, Wilbrand, HF. Anatomic variations of the chorda tympani canal. Acta Otolaryngol 1990;110:262–5CrossRefGoogle ScholarPubMed
19Noble, JH, Warren, FM, Labadie, RF, Dawant, BM. Automatic segmentation of the facial nerve and chorda tympani in CT images using spatially dependent feature values. Med Phys 2008;35:5375–84CrossRefGoogle ScholarPubMed