2021/11/25 | Research | Surgical technologies
When a cochlear implantation (CI) is performed robotically, the surplus electrode lead cannot be stored in the same way as in the manual surgery. This is because in the robotic procedure, instead of an access cavity, only a small-diameter drill hole directly to the inner ear is created. In an alternative approach, the Image Guided Therapy lab has now proposed extending the robotic procedure to also mill channels for the electrode lead fixation. These channels are designed to hold the electrode in place and protect them from external trauma.
The research team proposed to robotically mill a channel for the electrode lead based on patient-specific intraoperative planning before accessing the middle and inner ear by means of the same robotic surgery system. Through immobilization in a slight press fit to prevent mechanical fatigue and electrode migrations, such an approach could minimize the risk of iatrogenic intracochlear damage and create optimal conditions for a long implant life, according to the authors.
Work in an ex-vivo model demonstrated that accurate robotic milling coupled with adequately sized margins to vital structures lead to a safe procedure. The method of image-guided robotic bone removal presented is also capable of milling other delicate free-form cavities. Thus, it has significant potential for further otologic surgical procedures.
Link to the study
Image Guided Therapy