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

Abstract : 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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https://hal.umontpellier.fr/hal-02552165
Contributeur : Nathalie Salvy-Cordoba <>
Soumis le : jeudi 23 avril 2020 - 12:33:02
Dernière modification le : vendredi 15 mai 2020 - 12:22:09

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Juan Ansó, Cilgia Dür, Mareike Apelt, Frederic Venail, Olivier Scheidegger, et al.. Prospective Validation of Facial Nerve Monitoring to Prevent Nerve Damage During Robotic Drilling. Frontiers in Surgery, Frontiers Media S.A., 2019, 6, ⟨10.3389/fsurg.2019.00058⟩. ⟨hal-02552165⟩

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