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World Neurosurg. 2018 Aug;116:347-351. doi: 10.1016/j.wneu.2018.05.194. Epub 2018 Jun 2.

State of Robotic Mastoidectomy: Literature Review.

Author information

1
Institute of Medical Science, School of Graduate Studies, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Neurosurgery, Sunnybrook Health Sciences Centre, Brain Sciences Program/Imaging Research, Sunnybrook Research Institute, Toronto, Ontario, Canada; Division of Neurosurgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Biophotonics and Bioengineering Laboratory, Ryerson University, Toronto, Ontario, Canada. Electronic address: nirmeen.zagzoog@mail.utoronto.ca.
2
Institute of Medical Science, School of Graduate Studies, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Faculty of Applied Science and Engineering, University of Toronto, Toronto, Ontario, Canada; Division of Neurosurgery, Sunnybrook Health Sciences Centre, Brain Sciences Program/Imaging Research, Sunnybrook Research Institute, Toronto, Ontario, Canada; Biophotonics and Bioengineering Laboratory, Ryerson University, Toronto, Ontario, Canada; Department of Electrical and Computer Engineering, Ryerson University, Toronto, Ontario, Canada.

Abstract

Over the past 30 years, the application of robotics in the field of neurotology has grown. Robots are able to perform increasingly complex tasks with ever improving accuracy, allowing them to be used in a broad array of applications. A mastoidectomy, in which a drill is used to remove a portion of the mastoid part of the temporal bone at the base of the skull, is one such application. To determine the current state of neurotologic robotics in the specific context of mastoidectomy, a review of the literature was carried out. This qualitative review explores what has been done in this field to date, as well as what has yet to be done. Although the research suggests that robotics can be and has been successfully used to assist with mastoidectomy, it also suggests the incompleteness of robotic development in the field. At present, only 2 robotic systems have been approved by the U.S. Food and Drug Administration for neurosurgical use and the literature lacks evidence of meaningful clinical testing of new systems to change that. The cost of robotics also remains prohibitive. However, strides have been made, with at least 1 robot for mastoidectomy having reached the point of cadaveric trials. In addition, the research suggests some of the characteristics that should be considered when designing robots for mastoidectomy, such as burr size and the type of forces that should be applied. Overall, the outlook for robots in neurotology, particularly mastoidectomy, is bright but some hurdles still remain to be overcome.

KEYWORDS:

Craniotomy; Drills; Mastoidectomy; Neurotology; Otology; Robotics; Robots

PMID:
29870847
DOI:
10.1016/j.wneu.2018.05.194
[Indexed for MEDLINE]

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