Gawęcki Wojciech, Balcerowiak Andrzej, Podlawska Paulina, Borowska Patrycja, Gibasiewicz Renata, Szyfter Witold, Wierzbicka Małgorzata
Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, 60-355 Poznan, Poland.
Department of Otolaryngology and Laryngological Oncology, Heliodor Swiecicki Clinical Hospital, 60-355 Poznan, Poland.
J Clin Med. 2022 Nov 29;11(23):7045. doi: 10.3390/jcm11237045.
Robotics in otology has been developing in many directions for more than two decades. Current clinical trials focus on more accurate stapes surgery, minimally invasive access to the cochlea and less traumatic insertion of cochlear implant (CI) electrode arrays. In this study we evaluated the use of the RobOtol (Collin, Bagneux, France) otologic robot to insert CI electrodes into the inner ear with intraoperative ECochG analysis. This prospective, pilot study included two adult patients implanted with Advanced Bionics (Westinghouse PI, CA, USA) cochlear implant, with HiFocus™ Mid-Scala electrode array. The standard surgical approach was used. For both subjects, who had residual hearing in the implanted ear, intraoperative and postoperative ECochG was performed with the AIM system. The surgeries were uneventful. A credible ECochG response was obtained after complete electrode insertion in both cases. Preoperative BC thresholds compared to intraoperative estimated ECochG thresholds and 2-day postoperative BC thresholds had similar values at frequencies where all thresholds were measurable. The results of the ECochG performed one month after the surgery showed that in both patients the hearing residues were preserved for the selected frequencies. The RobOtol surgical robot allows for the correct, safe and gentle insertion of the cochlear implant electrode inside the cochlea. The use of electrocochleography measurements during robotic cochlear implantation offers an additional opportunity to evaluate and modify the electrode array insertion on an ongoing basis, which may contribute to the preservation of residual hearing.
二十多年来，耳科学中的机器人技术一直在多个方向发展。当前的临床试验聚焦于更精确的镫骨手术、微创进入耳蜗以及减少人工耳蜗（CI）电极阵列插入时的创伤。在本研究中，我们评估了使用RobOtol（法国巴涅ux的Collin公司）耳科机器人在术中进行耳蜗电图（ECochG）分析的情况下将CI电极插入内耳的情况。这项前瞻性的试点研究纳入了两名成年患者，他们植入了美国加利福尼亚州西屋PI公司Advanced Bionics的人工耳蜗，配备HiFocus™ 中阶电极阵列。采用了标准的手术方法。对于植入耳有残余听力的两名受试者，术中及术后均使用AIM系统进行耳蜗电图检查。手术过程顺利。在两例中，电极完全插入后均获得了可靠的耳蜗电图反应。在所有阈值均可测量的频率上，术前的骨导（BC）阈值与术中估计的耳蜗电图阈值以及术后2天的BC阈值具有相似的值。术后一个月进行的耳蜗电图检查结果显示，两名患者在所选频率上的听力残余均得以保留。RobOtol手术机器人能够在耳蜗内正确、安全且轻柔地插入人工耳蜗电极。在机器人辅助人工耳蜗植入过程中使用耳蜗电图测量提供了一个额外的机会，可在手术过程中持续评估和调整电极阵列的插入情况，这可能有助于保留残余听力。
