Yoshida Tadao, Kobayashi Masumi, Okubo Tomohito, Hatayama Naoyuki, Otsuka Shun, Wakana Kazuhito, Owaki Hirofumi, Matsuda Yasuhiro, Mikami Kei, Naito Munekazu
Department of Otorhinolaryngology Nagoya University Graduate School of Medicine Nagoya Japan.
Department of Anatomy Aichi Medical University, School of Medicine Nagakute Japan.
Laryngoscope Investig Otolaryngol. 2025 May 24;10(3):e70169. doi: 10.1002/lio2.70169. eCollection 2025 Jun.
Otological surgery requires exceptional precision and advanced surgical skills, particularly for procedures involving the tympanic membrane and middle ear structures. Microsurgical robotic systems have shown promise in enhancing surgical accuracy by minimizing tissue trauma and enabling remote operations. We aimed to evaluate the feasibility and effectiveness of a microsurgical telerobotic system for performing myringoplasty using an animal model.
This feasibility study was conducted with five rabbits (10 ears). Two surgeons performed myringoplasty using a microsurgical robot to create tympanic membrane perforations in both ears of the five rabbits. Subcutaneous tissue grafts were subsequently placed robotically to facilitate healing. Surgical video analysis of precision and postoperative observations of the tympanic membranes were conducted. The primary outcomes included (1) accuracy of tympanic membrane perforation and closure, (2) feasibility of robotic-assisted tissue graft placement, and (3) the success rate of tympanic membrane closure over a 2-week period.
Using a microsurgical robot, perforations were successfully created in the pars tensa of the tympanic membranes in 10 ears of five rabbits. Ten weeks after the procedure, the tympanic membrane perforations had closed, with subcutaneous tissue remaining at the repair sites. By week 2, complete closure of all perforation sites was observed.
This study is the first to demonstrate the feasibility of using microsurgical robots for myringoplasty. Robotic systems can be effectively integrated into otological procedures to potentially expand their applications to complex surgeries such as tympanoplasty, stapedotomy, and cochlear implantation. The applicability in humans should be evaluated in future studies.
V.
耳科手术需要极高的精准度和先进的手术技巧，尤其是涉及鼓膜和中耳结构的手术。显微外科机器人系统已显示出通过最小化组织创伤和实现远程操作来提高手术准确性的潜力。我们旨在使用动物模型评估一种显微外科远程机器人系统进行鼓膜成形术的可行性和有效性。
本可行性研究对5只兔子（10只耳朵）进行。两名外科医生使用显微外科机器人在5只兔子的双耳上制造鼓膜穿孔，随后通过机器人放置皮下组织移植物以促进愈合。对手术精度进行视频分析，并对鼓膜进行术后观察。主要结果包括：（1）鼓膜穿孔和闭合的准确性；（2）机器人辅助组织移植物放置的可行性；（3）2周内鼓膜闭合的成功率。
使用显微外科机器人，成功在5只兔子的10只耳朵的鼓膜紧张部制造了穿孔。术后10周，鼓膜穿孔已闭合，修复部位仍有皮下组织。到第2周时，观察到所有穿孔部位均完全闭合。
本研究首次证明了使用显微外科机器人进行鼓膜成形术的可行性。机器人系统可有效整合到耳科手术中，有可能将其应用扩展到诸如鼓室成形术、镫骨切除术和人工耳蜗植入等复杂手术。其在人类中的适用性应在未来研究中进行评估。
V级。
