Robot-assisted insertion of craniofacial implants—clinical experience

A medically approved robot system was clinically used to insert craniofacial implants into the skull for anchoring a silicone ear prosthesis. Additionally, a new process was developed for the preoperative manufacturing of the prosthesis using the computed tomography image data and a rapid prototyping technique. The navigated robot showed the surgeon intraoperatively the planned implant positions and guided the insertion procedure. The robot worked not automatically but interactively with the surgeon. In 13 patients, 30 implants were inserted with no intraoperative injuries. An absolute implant position accuracy of about ±1 mm and a relative accuracy between the implants of about ±0.2 mm were reached. This accuracy made it possible to apply the preoperatively manufactured ear prosthesis directly after surgery. The rehabilitation time for the patient was shortened. These clinical results were reached only by careful optimisation of each step of the intervention, the image acquisition, patient fixation and the intraoperative execution. The experience is good cause to use the robot system and the new manufacturing concept for anaplastology in other areas of the head as well.