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Prospective Validation of Facial Nerve Monitoring to Prevent Nerve Damage During Robotic Drilling

Facial nerve damage has a detrimental effect on a patient's life, therefore safety mechanisms to ensure its preservation are essential during lateral skull base surgery. During robotic cochlear implantation a trajectory passing the facial nerve at <0.5 mm is needed. Recently a stimulation pr...

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Autores principales: Ansó, Juan, Dür, Cilgia, Apelt, Mareike, Venail, Frederic, Scheidegger, Olivier, Seidel, Kathleen, Rohrbach, Helene, Forterre, Franck, Dettmer, Matthias S., Zlobec, Inti, Weber, Klaus, Matulic, Marco, Zoka-Assadi, Masoud, Huth, Markus, Caversaccio, Marco, Weber, Stefan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6781655/
https://www.ncbi.nlm.nih.gov/pubmed/31632981
http://dx.doi.org/10.3389/fsurg.2019.00058
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author Ansó, Juan
Dür, Cilgia
Apelt, Mareike
Venail, Frederic
Scheidegger, Olivier
Seidel, Kathleen
Rohrbach, Helene
Forterre, Franck
Dettmer, Matthias S.
Zlobec, Inti
Weber, Klaus
Matulic, Marco
Zoka-Assadi, Masoud
Huth, Markus
Caversaccio, Marco
Weber, Stefan
author_facet Ansó, Juan
Dür, Cilgia
Apelt, Mareike
Venail, Frederic
Scheidegger, Olivier
Seidel, Kathleen
Rohrbach, Helene
Forterre, Franck
Dettmer, Matthias S.
Zlobec, Inti
Weber, Klaus
Matulic, Marco
Zoka-Assadi, Masoud
Huth, Markus
Caversaccio, Marco
Weber, Stefan
author_sort Ansó, Juan
collection PubMed
description Facial nerve damage has a detrimental effect on a patient's life, therefore safety mechanisms to ensure its preservation are essential during lateral skull base surgery. During robotic cochlear implantation a trajectory passing the facial nerve at <0.5 mm is needed. Recently a stimulation probe and nerve monitoring approach were developed and introduced clinically, however for patient safety no trajectory was drilled closer than 0.4 mm. Here we assess the performance of the nerve monitoring system at closer distances. In a sheep model eight trajectories were drilled to test the setup followed by 12 trajectories during which the ENT surgeon relied solely on the nerve monitoring system and aborted the robotic drilling process if intraoperative nerve monitoring alerted of a distance <0.1 mm. Microcomputed tomography images and histopathology showed prospective use of the technology prevented facial nerve damage. Facial nerve monitoring integrated in a robotic system supports the surgeon's ability to proactively avoid damage to the facial nerve during robotic drilling in the mastoid.
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spelling pubmed-67816552019-10-18 Prospective Validation of Facial Nerve Monitoring to Prevent Nerve Damage During Robotic Drilling Ansó, Juan Dür, Cilgia Apelt, Mareike Venail, Frederic Scheidegger, Olivier Seidel, Kathleen Rohrbach, Helene Forterre, Franck Dettmer, Matthias S. Zlobec, Inti Weber, Klaus Matulic, Marco Zoka-Assadi, Masoud Huth, Markus Caversaccio, Marco Weber, Stefan Front Surg Surgery Facial nerve damage has a detrimental effect on a patient's life, therefore safety mechanisms to ensure its preservation are essential during lateral skull base surgery. During robotic cochlear implantation a trajectory passing the facial nerve at <0.5 mm is needed. Recently a stimulation probe and nerve monitoring approach were developed and introduced clinically, however for patient safety no trajectory was drilled closer than 0.4 mm. Here we assess the performance of the nerve monitoring system at closer distances. In a sheep model eight trajectories were drilled to test the setup followed by 12 trajectories during which the ENT surgeon relied solely on the nerve monitoring system and aborted the robotic drilling process if intraoperative nerve monitoring alerted of a distance <0.1 mm. Microcomputed tomography images and histopathology showed prospective use of the technology prevented facial nerve damage. Facial nerve monitoring integrated in a robotic system supports the surgeon's ability to proactively avoid damage to the facial nerve during robotic drilling in the mastoid. Frontiers Media S.A. 2019-10-01 /pmc/articles/PMC6781655/ /pubmed/31632981 http://dx.doi.org/10.3389/fsurg.2019.00058 Text en Copyright © 2019 Ansó, Dür, Apelt, Venail, Scheidegger, Seidel, Rohrbach, Forterre, Dettmer, Zlobec, Weber, Matulic, Zoka-Assadi, Huth, Caversaccio and Weber. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Ansó, Juan
Dür, Cilgia
Apelt, Mareike
Venail, Frederic
Scheidegger, Olivier
Seidel, Kathleen
Rohrbach, Helene
Forterre, Franck
Dettmer, Matthias S.
Zlobec, Inti
Weber, Klaus
Matulic, Marco
Zoka-Assadi, Masoud
Huth, Markus
Caversaccio, Marco
Weber, Stefan
Prospective Validation of Facial Nerve Monitoring to Prevent Nerve Damage During Robotic Drilling
title Prospective Validation of Facial Nerve Monitoring to Prevent Nerve Damage During Robotic Drilling
title_full Prospective Validation of Facial Nerve Monitoring to Prevent Nerve Damage During Robotic Drilling
title_fullStr Prospective Validation of Facial Nerve Monitoring to Prevent Nerve Damage During Robotic Drilling
title_full_unstemmed Prospective Validation of Facial Nerve Monitoring to Prevent Nerve Damage During Robotic Drilling
title_short Prospective Validation of Facial Nerve Monitoring to Prevent Nerve Damage During Robotic Drilling
title_sort prospective validation of facial nerve monitoring to prevent nerve damage during robotic drilling
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6781655/
https://www.ncbi.nlm.nih.gov/pubmed/31632981
http://dx.doi.org/10.3389/fsurg.2019.00058
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