Robot-assisted placement of craniofacial implants.
OBJECTIVE
The purpose of this study was to improve and accelerate the rehabilitation process for patients with severe ear microtia with an implant-anchored auricular prosthesis. A medically approved robot system was used to place the craniofacial implants and a new process was developed for preoperative fabrication of the prosthesis using a rapid prototyping technique.


METHODS
Preoperatively, after computerized tomography, the implant positions were determined in a planning tool according to bone availability and esthetic considerations. Intraoperatively, the robot showed the surgeon the planned implant positions and guided the placement procedure.


RESULTS
The accuracy measurements showed that with this robot system, absolute implant position accuracy of approximately -0.5 +/- 0.4 mm, a relative accuracy between the implants of approximately 0.2 +/- 0.5 mm, and a deviation from the parallel position of approximately 0.6 +/- 0.5 degrees were achieved. Thirty implants were placed in 13 patients with robot assistance with no intraoperative injuries.


CONCLUSIONS
This technique made it possible to apply the preoperatively fabricated auricular prosthesis directly after surgery.


CONCLUSIONS
From this experience it can be concluded that the robot system and the new manufacturing concept for anaplastology can be applied advantageously in other areas of the head as well.
Clinic for Maxillofacial Sugery-Clinical Navigation and Robotics, Charité University Medicine, Campus Virchow Clinic, Berlin, Germany. martin.klein@charite.de
Martin
M
Klein
Andreas
A
Hein
Tim
T
Lueth
Jürgen
J
Bier
D000293:Adolescent; D000328:Adult; D004431:Ear, External / Q000002:abnormalities; D004954:Esthetics; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008280:Magnetics / Q000295:instrumentation; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D010347:Patient Care Planning; D019904:Polymethyl Methacrylate; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019919:Prosthesis Implantation; D012371:Robotics / Q000295:instrumentation / Q000379:methods; D012826:Silicone Elastomers; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D012826:Silicone Elastomers; D019904:Polymethyl Methacrylate