Robot-assisted placement of craniofacial implants

Purpose: 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. Materials and Methods: Preoperatively, after computerized tomography, the implant positions were determined in a planning tool according to bone availability and esthetic considerations. Intra operatively, 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. Discussion: This technique made it possible to apply the preoperatively fabricated auricular prosthesis directly after surgery. Conclusion: 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.