使用Otoarm-Otodrive系统在人工耳蜗植入中机器人辅助电极插入的早期临床经验。
Early Clinical Experience With Robot-Assisted Electrode Insertion in Cochlear Implantation Using the Otoarm-Otodrive System.
文献信息
| PMID | 42708541 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Kevin Jer V David |
| 作者单位 | Department of Otolaryngology - Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada. |
| 期刊 | Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale |
| SCI 分区 | Q1 |
| IF | 2.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
重要性： 手动人工耳蜗植入（CI）电极插入仍依赖于外科医生，并可能导致耳蜗内创伤。机器人辅助系统，如新型Otoarm-Otodrive，提供超慢速度的电动控制，旨在最小化力度波动和压力变化，从而可能改善听力保留和手术一致性。
目的： 描述使用Otoarm-Otodrive系统进行机器人辅助人工耳蜗植入（CI）的机构经验、手术流程整合及可行性。
设计： 对50例连续机器人辅助CI病例的回顾性描述性研究。
地点： 加拿大一家三级转诊耳科中心。
参与者： 2025年1月至10月期间使用MED-EL设备接受人工耳蜗植入且无耳蜗畸形或骨化的50例成年患者。
干预： 使用Otoarm-Otodrive（MED-EL）系统进行机器人辅助耳蜗电极阵列插入。
主要结局指标： 可行性（设置和插入时间）、插入深度、术中挑战以及融入手术流程的情况。
结果： 机器人设置和对准的额外时间平均为374秒。电极插入持续时间以标准化速率0.1毫米/秒进行，平均为444秒。30例的术后Otoplan分析显示平均角度插入深度为575°。未发生面神经麻痹或感染等重大并发症，也未发生设备相关并发症。除1例外，所有病例均实现完全插入。
结论： 使用Otoarm-Otodrive系统进行机器人辅助耳蜗电极插入安全、可重复，且易于整合到标准CI流程中。
相关性： 这是北美首次使用Otoarm-Otodrive系统的经验，证明了机器人人工耳蜗植入作为实现无创植入一步的可行性。未来研究将评估听力保留益处和成本效益，以促进更广泛采用。
英文摘要
IMPORTANCE: Manual cochlear implant (CI) electrode insertion remains surgeon-dependent and may contribute to intracochlear trauma. Robotic-assisted systems, such as the new Otoarm-Otodrive, offer motorized control at ultra-slow speeds that aim to minimize force fluctuations and pressure changes, potentially improving hearing preservation and surgical consistency.
OBJECTIVE: To describe the institutional experience, surgical workflow integration, and feasibility of robot-assisted cochlear implantation (CI) using the Otoarm-Otodrive system.
DESIGN: Retrospective descriptive study of 50 consecutive robot-assisted CI cases.
SETTING: Tertiary referral otology center in Canada.
PARTICIPANTS: Fifty Adult patients undergoing cochlear implantation without cochlear malformation or ossification using a MED-EL device from January to October 2025.
INTERVENTION: Robot-assisted cochlear electrode array insertion using the Otoarm-Otodrive (MED-EL) system.
MAIN OUTCOME MEASURES: Feasibility (setup and insertion times), insertion depth, intraoperative challenges, and integration into operative workflow.
RESULTS: The additional time for robot setup and alignment averaged 374 seconds. Mean electrode insertion duration, performed at a standardized rate of 0.1 mm/second, was 444 seconds. Postoperative Otoplan analysis in 30 cases demonstrated a mean angular insertion depth of 575°. No major complications such as facial nerve palsy or infections, and no device-related complications occurred. All but 1 case achieved full insertion.
CONCLUSIONS: Robot-assisted cochlear electrode insertion using the Otoarm-Otodrive system is safe, reproducible, and easily integrated into standard CI workflow.
RELEVANCE: This first North American experience in using the Otoarm-Otodrive system demonstrates the feasibility of robotic cochlear implant insertion as a step toward achieving atraumatic implantation. Future studies will assess hearing preservation benefits and cost-effectiveness for broader adoption.