Open AccessApplied Force during Piston Prosthesis Placement in a 3D‐Printed Model: Freehand vs Robot‐Assisted Techniques
Author(s) -
Razavi Christopher R.,
Wilkening Paul R.,
Yin Rui,
Lamaison Nicolas,
Taylor Russell H.,
Carey John P.,
Creighton Francis X.
Publication year - 2019
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599818815144
Subject(s) - incus , stapes , prosthesis , piston (optics) , orthodontics , biomedical engineering , computer science , medicine , middle ear , artificial intelligence , surgery , physics , wavefront , optics
Objectives To describe a 3D‐printed middle ear model that quantifies the force applied to the modeled incus. To compare the forces applied during placement and crimping of a stapes prosthesis between the Robotic ENT Microsurgery System ( REMS ) and the freehand technique in this model. Study Design Prospective feasibility study. Setting Robotics laboratory. Subjects and Methods A middle ear model was designed and 3D printed to facilitate placement and crimping of a piston prosthesis. The modeled incus was mounted to a 6–degree of freedom force sensor to measure forces/torques applied on the incus. Six participants—1 fellowship‐trained neurotologist, 2 neurotology fellows, and 3 otolaryngology–head and neck surgery residents—placed and crimped a piston prosthesis in this model, 3 times freehand and 3 times REMS assisted. Maximum force applied to the incus was then calculated for prosthesis placement and crimping from force/torque sensor readings for each trial. Robotic and freehand outcomes were compared with a linear regression model. Results Mean maximum magnitude of force during prosthesis placement was 126.4 ± 73.6 mN and 105.0 ± 69.4 mN for the freehand and robotic techniques, respectively ( P =. 404). For prosthesis crimping, the mean maximum magnitude of force was 469.3 ± 225.2 mN for the freehand technique and 272.7 ± 97.4 mN for the robotic technique ( P =. 049). Conclusions Preliminary data demonstrate that REMS ‐assisted stapes prosthesis placement and crimping are feasible with a significant reduction in maximum force applied to the incus during crimping with the REMS in comparison with freehand.