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小儿机器人耳蜗植入术在体模中的可行性。

Feasibility of Pediatric Robotic Cochlear Implantation in Phantoms.

机构信息

ARTORG Center for Biomedical Engineering.

ENT Department of Inselspital, University of Bern, Bern, Switzerland.

出版信息

Otol Neurotol. 2020 Feb;41(2):e192-e200. doi: 10.1097/MAO.0000000000002434.

Abstract

OBJECTIVE

To demonstrate the feasibility of robotic cochlear implant surgery in subject specific pediatric phantoms.

STUDY DESIGN

Pilot study.

MATERIALS AND METHODS

Computed tomographic preoperative encrypted data of 10 pediatric subjects (total of 20 sides) between 8 months and 48 months old, who underwent cochlear implant surgery were studied. Four datasets (n = 8 sides) were selected for investigation of the complete robotic procedure including middle and inner ear access and electrode insertion.

RESULTS

The planning of the safe trajectory for the robotic approach was possible in 17 of the cases. In three sides, planning the trajectory was not possible due to the small size of the facial recess. Bone thickness study demonstrated average sufficient bone thickness at the site of screw implantation in general. The complete robotic procure including the drilling and insertion was successfully carried out on all the created phantoms.

CONCLUSION

With this work we have demonstrated the feasibility of planning and performing a robotic middle and inner ear access and cochlear implantation (CI) in phantom models of pediatric subjects. To develop and validate the proposed procedure for use in children, next stage optimization of the current surgical workflow and adaptation of the surgical material to pediatric population is necessary.

摘要

目的

展示在特定于儿科的人体模型中进行机器人耳蜗植入手术的可行性。

研究设计

试点研究。

材料和方法

研究了 10 名 8 个月至 48 个月大的儿童患者(共 20 侧)的计算机断层扫描术前加密数据,这些患者均接受了耳蜗植入手术。选择了四个数据集(n=8 侧)来调查完整的机器人手术程序,包括中耳和内耳的通道和电极插入。

结果

在 17 例中,机器人方法的安全轨迹规划是可行的。在 3 侧,由于面神经隐窝较小,规划轨迹是不可能的。骨厚度研究表明,在一般的植入螺钉部位有足够的平均骨厚度。在所有创建的模型上,均成功完成了包括钻孔和插入在内的完整机器人手术。

结论

通过这项工作,我们已经证明了在儿科患者的人体模型中进行机器人中耳和内耳通道及耳蜗植入(CI)的规划和执行的可行性。为了在儿童中开发和验证所提出的程序,需要对当前手术工作流程进行下一阶段的优化,并对手术材料进行儿科人群的适应性调整。

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