Cochlea-Implantation (CI) und Robotik: Erfahrungen mit dem HEARO® - System in Deutschland

Introduction: Robotic systems are currently in the focus of further development in CI with the aim of improving surgical precision in a reproducible manner and minimizing trauma. The HEARO® robot is the first clinical system that can autonomously perform a drilling channel for CI from the skull surface to the round window with sufficiently high accuracy.

Methods: This work is based on the analysis of 6 patients who have been operated on with the HEARO® to date and a summary of the evaluations of the process sequence and planning. The calculation of the trajectory and distances to critical structures and verification of accuracy was carried out using the OTOPLAN® software, the process was defined using the BPMN 2.0 modeling language and the patients operated on with HEARO® were asked about their affinity for technology (ATI Scale) using a questionnaire.

Results: Screening for the feasibility of CI using the HEARO® showed that approx. 37% of patients had to be excluded for anatomical reasons. In 4/6 patients to date, the CI was performed completely with the HEARO®. In 2 cases it was necessary to switch to conventional mastoidectomy. The width of the facial nerve in the planning was 3.1 -3.5 mm with a minimum distance of 0.46 -0.5 mm between the facial nerve and the planned trajectory. In all 4 cases a complete insertion of the electrode was achieved via the drilled channel (insertion depth between 555° and 610°). In one case with residual hearing, this was preserved. All patients interviewed showed an increased affinity for technology.

Discussion: The HEARO® robot offers suitable patients a system for individualized planning and execution of the best possible trajectory to the inner ear and enables minimally invasive access to the round window with high precision.

supported by MED-EL Elektromedizinische Geräte Deutschland GmbH, Moosstraße 7, 82319 Starnberg, Germany