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Mechatronic feasibility of minimally invasive, atraumatic cochleostomy.

Williamson T, Du X, Bell B, Coulson C, Caversaccio M, Proops D, Brett P, Weber S - Biomed Res Int (2014)

Bottom Line: Robotic assistance in the context of lateral skull base surgery, particularly during cochlear implantation procedures, has been the subject of considerable research over the last decade.The use of robotics during these procedures has the potential to provide significant benefits to the patient by reducing invasiveness when gaining access to the cochlea, as well as reducing intracochlear trauma when performing a cochleostomy.Access to the middle ear was successfully achieved through the facial recess without damage to surrounding anatomical structures; cochleostomy was completed at the planned position with the endosteum remaining intact after drilling as confirmed by microscope evaluation.

View Article: PubMed Central - PubMed

Affiliation: ARTORG Center for Biomedical Engineering Research, University of Bern, 3010 Bern, Switzerland.

ABSTRACT
Robotic assistance in the context of lateral skull base surgery, particularly during cochlear implantation procedures, has been the subject of considerable research over the last decade. The use of robotics during these procedures has the potential to provide significant benefits to the patient by reducing invasiveness when gaining access to the cochlea, as well as reducing intracochlear trauma when performing a cochleostomy. Presented herein is preliminary work on the combination of two robotic systems for reducing invasiveness and trauma in cochlear implantation procedures. A robotic system for minimally invasive inner ear access was combined with a smart drilling tool for robust and safe cochleostomy; evaluation was completed on a single human cadaver specimen. Access to the middle ear was successfully achieved through the facial recess without damage to surrounding anatomical structures; cochleostomy was completed at the planned position with the endosteum remaining intact after drilling as confirmed by microscope evaluation.

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The surgical smart drilling system is capable of drilling an atraumatic cochleostomy, allowing access to the inner ear for cochlear electrode array insertion.
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fig1: The surgical smart drilling system is capable of drilling an atraumatic cochleostomy, allowing access to the inner ear for cochlear electrode array insertion.

Mentions: The surgical smart drill system is the mechatronic system used to produce consistent windows onto the endosteum. This system enables manual positioning onto the drilling trajectory and then the automatic feed control of the tool point with respect to the deforming tissue and avoiding penetration through the endosteal membrane, as shown in Figure 1. The control strategy of the smart drill is based on the discrimination of simultaneous features in the force and torque transients during drilling. The onset of breakthrough causes a sharp result in the increase of torque signal and simultaneous roll-off of the feed force signal (shown as stage 3 in Figure 2 [18, 19]). While these simultaneous force transient features are always present when approaching a tissue interface, the values and prominence of the peaks in force and torque vary according to stiffness, drill feed velocity, tissue hardness, and sharpness of the drill bit. The control algorithms use the simultaneous features to discriminate the drilling conditions, tissues, and tissue interfaces to enable precision in the process. The robotic system integrates the drilling machine that accommodates actuators for feed and drill rotation, sensing methods for force and torque, standard drill bits, an adjustable support arm, a remote pendant, an electronics box accommodating the main processor, sensory discrimination algorithms, control strategy selection, amplifiers, and indicators showing the state of the process. A laptop can be connected to provide further information.


Mechatronic feasibility of minimally invasive, atraumatic cochleostomy.

Williamson T, Du X, Bell B, Coulson C, Caversaccio M, Proops D, Brett P, Weber S - Biomed Res Int (2014)

The surgical smart drilling system is capable of drilling an atraumatic cochleostomy, allowing access to the inner ear for cochlear electrode array insertion.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4109217&req=5

fig1: The surgical smart drilling system is capable of drilling an atraumatic cochleostomy, allowing access to the inner ear for cochlear electrode array insertion.
Mentions: The surgical smart drill system is the mechatronic system used to produce consistent windows onto the endosteum. This system enables manual positioning onto the drilling trajectory and then the automatic feed control of the tool point with respect to the deforming tissue and avoiding penetration through the endosteal membrane, as shown in Figure 1. The control strategy of the smart drill is based on the discrimination of simultaneous features in the force and torque transients during drilling. The onset of breakthrough causes a sharp result in the increase of torque signal and simultaneous roll-off of the feed force signal (shown as stage 3 in Figure 2 [18, 19]). While these simultaneous force transient features are always present when approaching a tissue interface, the values and prominence of the peaks in force and torque vary according to stiffness, drill feed velocity, tissue hardness, and sharpness of the drill bit. The control algorithms use the simultaneous features to discriminate the drilling conditions, tissues, and tissue interfaces to enable precision in the process. The robotic system integrates the drilling machine that accommodates actuators for feed and drill rotation, sensing methods for force and torque, standard drill bits, an adjustable support arm, a remote pendant, an electronics box accommodating the main processor, sensory discrimination algorithms, control strategy selection, amplifiers, and indicators showing the state of the process. A laptop can be connected to provide further information.

Bottom Line: Robotic assistance in the context of lateral skull base surgery, particularly during cochlear implantation procedures, has been the subject of considerable research over the last decade.The use of robotics during these procedures has the potential to provide significant benefits to the patient by reducing invasiveness when gaining access to the cochlea, as well as reducing intracochlear trauma when performing a cochleostomy.Access to the middle ear was successfully achieved through the facial recess without damage to surrounding anatomical structures; cochleostomy was completed at the planned position with the endosteum remaining intact after drilling as confirmed by microscope evaluation.

View Article: PubMed Central - PubMed

Affiliation: ARTORG Center for Biomedical Engineering Research, University of Bern, 3010 Bern, Switzerland.

ABSTRACT
Robotic assistance in the context of lateral skull base surgery, particularly during cochlear implantation procedures, has been the subject of considerable research over the last decade. The use of robotics during these procedures has the potential to provide significant benefits to the patient by reducing invasiveness when gaining access to the cochlea, as well as reducing intracochlear trauma when performing a cochleostomy. Presented herein is preliminary work on the combination of two robotic systems for reducing invasiveness and trauma in cochlear implantation procedures. A robotic system for minimally invasive inner ear access was combined with a smart drilling tool for robust and safe cochleostomy; evaluation was completed on a single human cadaver specimen. Access to the middle ear was successfully achieved through the facial recess without damage to surrounding anatomical structures; cochleostomy was completed at the planned position with the endosteum remaining intact after drilling as confirmed by microscope evaluation.

Show MeSH
Related in: MedlinePlus