Department of Otorhinolaryngology and Head & Neck Surgery, University Hospital UZ Brussel, Vrije Universiteit Brussel, Brussels Health Campus, Brussels, Belgium.
Department of Otorhinolaryngology, Klinikum Bad Salzungen, Bad Salzungen, Germany.
J Craniofac Surg. 2021 Oct 1;32(7):e672-e676. doi: 10.1097/SCS.0000000000007858.
Ear surgery requires magnified imaging of anatomical structures from its beginning to achieve safe and successful surgical outcomes. The historical evolution of magnification in otology has developed from monocular to binocular, and to three-dimensional and even to digital in modern times. Current technological advancements pursue high-quality visualization for the best surgical outcomes but also ergonomic for surgeons. Here, we evaluated the usability of such new technology in common otological surgeries like cochlear implantation and stapedectomy for the first time in patients. A three-dimensional camera mounted to a robot arm has hands-free control by goggles worn by the surgeon on a head mount. The camera at a distance of the patients but can also be draped in a sterile way that it forms a barrier tent between patient and surgical personnel in the theatre. The main reason to evaluate the feasibility of this new exoscope was driven by COVID-19 obligate measures for elective surgery such as hearing restoration. This new technology can be considered an important advantage for the surgeons working in microsurgery to perform their elective operations without aerosolization of the drill rinsing water possibly containing contaminated tissue. From a subjective point of view, the image quality is equivalent to conventional microscopes to provide safe otologic surgery.
耳科手术需要从一开始就对解剖结构进行放大成像，以实现安全和成功的手术结果。耳科学中放大技术的历史演变已经从单目发展到双目，再发展到现代的三维，甚至数字化。目前的技术进步追求高质量的可视化效果，以实现最佳的手术效果，同时也追求手术医生的人体工程学设计。在这里，我们首次在患者中评估了这种新技术在常见耳科手术（如人工耳蜗植入和镫骨切除术）中的可用性。一个安装在机械臂上的三维摄像机通过外科医生佩戴的头戴式护目镜进行免提控制。摄像机距离患者有一定距离，但也可以以无菌的方式覆盖，在手术室内形成一个患者和手术人员之间的隔离帐篷。评估这种新型手术显微镜的可行性的主要原因是出于对听力恢复等选择性手术的 COVID-19 强制性措施的考虑。这项新技术可以被认为是对在显微镜下进行手术的医生的一个重要优势，因为他们可以在不使可能含有污染组织的钻头冲洗水雾化的情况下进行选择性手术。从主观的角度来看，图像质量与传统显微镜相当，能够提供安全的耳科手术。
