耳科机器人在辅助人工耳蜗电极植入中的初步应用

Preliminary application of robot-assisted electrode insertion in cochlear implantation

目的探讨在人工耳蜗植入手术中应用耳科机器人技术辅助电极植入的安全性和临床意义。方法报道2019年10月国内首例应用耳科手术机器人(RobOtol?)辅助实施人工耳蜗电极植入(诺尔康CS-10A TM),并对手术安全性和疗效进行分析。结果该例成人女性患者顺利应用耳科机器人辅助实施电极植入,机器人系统安置、调试时间约6 min。术中缓慢、全鼓阶植入人工耳蜗电极,机器人执行末梢对术野组织无损伤。术中植入电极的阻抗及神经遥测反应均良好。无术后并发症。术后人工耳蜗系统运作良好,听觉重建效果理想。结论耳科手术机器人在不自主震颤消除及精细操作放大上具有一定优势,可以安全地在人工耳蜗植入手术中辅助电极植入,实现电极微创、全鼓阶植入,良好保留内耳精细结构。

Objective To evaluate the safety and outcomes of robot-assisted electrode insertion in cochlear implantation.Methods We first reported the case of robot-assisted electrode insertion of cochlear implantation in October 2019.A new slim electrode array of Nurotron cochlear implant(CS-10A TM)and RobOtol®robot system were used in this case.The robotic assistance procedures,surgical outcomes were analyzed.Results Robot-assisted electrode insertion was successfully performed in this adult patient.The preparation of robot system cost six minutes,the electrode array was slowly and fully inserted into tympanic scala with robot assistance.No damage in the surgical field occurred by the robotic instrument.Intraoperative electrode impedances and neural response measurements were normal.No postoperative complications occurred.Up to three months of follow up after implantation,the cochlear implant functioned well and rehabilitated hearing was satisfactory.Conclusion Otological robot system shows its advantage in the elimination of human involuntary tremors and the augmentation of accuracy during micromanipulation,it could safely assist cochlear implantation to realize minimally invasive and full tympanic scala insertion of the electrode array,and to ensure the good preservation of the intracochlear fine structure.