Analysis of forces during robot-assisted and manual manipulations of mobile and fixed footplate in temporal bone specimens

Hannah Daoudi, Renato Torres, Stéphane Mazalaigue, Olivier Sterkers, Evelyne Ferrary, Yann Nguyen

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To evaluate the forces involved in different manipulations, manual or robot-assisted, applied to the ossicular chain, on normal temporal bones and on an anatomical model of otosclerosis. Methods: Thirteen cadaveric temporal bones, with mobile footplates or with footplates that were fixed using hydroxyapatite cement, were manipulated, manually or using a robotic arm (RobOtol®). “Short contact” of a mobile footplate was the weakest interaction on the incus. “Long contact” was the same manipulation held for 10 s. “Mobilization” was the smallest visualized movement of the mobile footplate, or the movement necessary to regain mobility of the fixed footplate. A six-axis force sensor (Nano17, ATI) measured the maximal peak of forces, summation of forces applied, and yank. Results: Maximal forces during short (~4 mN) and long contact (~15 mN) were similar for manual and robot-assisted manipulations. For manual manipulation, yank measured during long contact was twice as high compared to robot-assisted manipulation: 6 ± 2.4 (n = 5) and 3 ± 1.3 mN/s (n = 5), respectively (mean ± SD, p < 0.02). For mobilization of the mobile footplate, maximal forces during mobilization were similar during manual and robot-assisted manipulations, respectively: 12 ± 2.5 (n = 6) and 19 ± 7.6 mN (n = 7). Compared with mobilization of a mobile footplate, mobilization of a fixed footplate required ~ 60 and ~ 27 times higher maximal forces for manual and robot-assisted manipulations, respectively: 724 ± 366.4 and 507 ± 283.2 mN. Yank was twice as high during manual manipulation compared to robot-assisted manipulation (p < 0.05). Conclusion: Robot-assisted manipulation of the ossicular chain was reliable. Our anatomical model of otosclerosis was successfully developed requiring higher forces for stapes mobilization.

Original languageEnglish
Pages (from-to)4269-4277
Number of pages9
JournalEuropean Archives of Oto-Rhino-Laryngology
Volume278
Issue number11
DOIs
StatePublished - Nov 2021

Bibliographical note

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.

Keywords

  • Mobilization forces
  • Ossicular chain
  • Otosclerosis
  • Stapes
  • Surgery

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