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      Design, Kinematic Optimization, and Evaluation of a Teleoperated System for Middle Ear Microsurgery

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          Abstract

          Middle ear surgery involves the smallest and the most fragile bones of the human body. Since microsurgical gestures and a submillimetric precision are required in these procedures, the outcome can be potentially improved by robotic assistance. Today, there is no commercially available device in this field. Here, we describe a method to design a teleoperated assistance robotic system dedicated to the middle ear surgery. Determination of design specifications, the kinematic structure, and its optimization are detailed. The robot-surgeon interface and the command modes are provided. Finally, the system is evaluated by realistic tasks in experimental dedicated settings and in human temporal bone specimens.

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          A robot with improved absolute positioning accuracy for CT guided stereotactic brain surgery.

          Y. Kwoh, J. Hou, E. JONCKHEERE … (1988)
          Article 0 comments Cited 174 times – based on 0 reviews     Review now
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            Stapedectomy versus stapedotomy: comparison of results with long-term follow-up.

            Howard House, Marlan R. Hansen, Abdul Al Dakhail … (2002)
            To compare the effectiveness and long-term stability of hearing results between stapedectomy and small fenestra stapedotomy in patients with conductive hearing loss due to otosclerosis. Retrospective review of prospectively collected audiometric data. The hearing results and complication rates of 209 ears with long-term follow-up that underwent either stapedectomy or stapedotomy by the senior author (h.p.h.) between 1961 and 1989 were compared. Forty-two patients underwent stapedectomy in one ear and stapedotomy in the opposite ear, permitting a paired case review of the results in these patients. The techniques were compared with respect to initial and late hearing results and change of the results over time. Patients undergoing stapedectomy and stapedotomy were followed for an average of 11.5 and 6.0 years, respectively. There were no statistically significant differences in initial or late postoperative pure-tone average (PTA), PTA air-bone gap, speech discrimination scores, or incidence of sensorineural hearing loss between the two groups. Ears treated by stapedotomy showed statistically better initial and late postoperative 4-kHz air-conduction threshold and initial 4-kHz air-bone gap, but the gap difference was not significant with late follow-up. There was no significant difference in the percentage of patients with air-bone gap closure within 10 dB for any frequency other than 4 kHz at the initial postoperative test. Importantly, the successful outcomes in both groups were stable over long-term follow-up. Results were the same when comparing the two procedures in patients having undergone both. These results show that, in the hands of an experienced surgeon, either technique provides satisfactory and stable long-term results.
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              An autonomous surgical robot for drilling a cochleostomy: preliminary porcine trial.

              Joanne C. Coulson, R Taylor, Simon A. Reid … (2008)
              To produce an autonomous drilling robot capable of performing a bony cochleostomy whilst minimising the damage to the underlying cochlear endosteum. In this laboratory based study, a robotic drill was designed to measure the changes in force and torque experienced by the tool point during the drilling process. This information is used to predict the point of breakthrough and stop the drill prior to damaging the underlying endosteal membrane. Aston University. Five porcine cochleas. An assessment was made of whether a successful bony cochleostomy was performed, the integrity of endosteal membrane was then assessed. The autonomous surgical robotic drill successfully performed a bony cochleostomy and stopped without damaging the endosteal membrane in all five cases. The autonomous surgical robotic drill can perform a cochleostomy whilst minimising the trauma to the endosteal membrane. The system allows information about the state of the drilling process to be derived using force and torque data from the tool point. This information can be used to effectively predict drill breakthrough and implement a control strategy to minimise drill penetration beyond the far surface.
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                Author and article information

                Journal
                Journal ID (nlm-ta): ScientificWorldJournal
                Journal ID (iso-abbrev): ScientificWorldJournal
                Journal ID (publisher-id): TSWJ
                Title: The Scientific World Journal
                Publisher: The Scientific World Journal
                ISSN (Electronic): 1537-744X
                Publication date Collection: 2012
                Publication date (Electronic): 13 August 2012
                Volume: 2012
                Electronic Location Identifier: 907372
                Affiliations
                1Sorbonne Paris Cité, INSERM UMR-S 867, Université Paris Diderot, 75018 Paris, France
                2ISIR, CNRS UMR 7222, Université Pierre et Marie Curie, 75005 Paris, France
                3Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale, Hôpital Beaujon, AP-HP, 92110 Clichy, France
                Author notes

                Academic Editors: D. Ayache, C. Bao, and P. A. Schachern

                Article
                DOI: 10.1100/2012/907372
                PMC ID: 3425830
                PubMed ID: 22927789
                SO-VID: 43a52b01-2827-4e75-b334-15288cfae321
                Copyright © Copyright © 2012 Mathieu Miroir et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 23 May 2012
                Date accepted : 27 June 2012
                Categories
                Subject: Research Article

                ScienceOpen disciplines: Uncategorized
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                ScienceOpen disciplines: Uncategorized

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