Forschung

Eine Auswahl aktueller Forschungsprojekte

An der Klinik für Hals-, Nasen- und Ohrenkrankheiten, Kopf- und Halschirurgie (HNO) werden laufend zahlreiche interessante wissenschaftliche Projekte bearbeitet. Hier eine Auswahl:

Bone Anchored Port for Hemodialysis. (BAP)

The device:  The BAP is comprised of a casing (the actual implant), an ingenious valve system consisting of a main valve and a subvalve in an internal housing, a catheter and a replaceable cap. The catheter ends, like any other longterm hemodialysis catheter, in the right atrium of the heart. However, its course is straighter, which allows higher flow rates during dialysis and causes less turbulence in the catheter. This in turn has a positive impact on the durability of the port because fewer catheter occlusions occur. The internal housing contains a tubing system that is normally open. Only when the main valve is being exchanged it is closed from the outside with a clamping mechanism. The main valve protects the interior of the port and the catheter against air ingress and pathogens and it is changed regularly by dialysis nursing staff. Connection to the dialysis machine happens via an adapter that is simply clicked onto the port. After each dialysis the port is eventually protected with a new cap.

Benefits:   Access site in a tissue zone with good circulation and reduced infection risk, no repeated painful vessel puncture, no postoperative bleeding, selfcontained system with replaceable components (better hygiene), safety barrier between port and catheter tip (reduced - Fewer catheter blockages due to a straighter course of the catheter (hardly any turbulence), stable anchorage in the bone allows first dialysis shortly after implantation (good primary stability), Better resistance to everyday influences.

To date, 5 patients underwent BAP surgery in our department.

The Bone Anchored Port was developed in close collaboration with the following institutions. Department of ENT, Head and Neck Surgery, Nephrology & Vascular surgery University Hospital, Bern, Switzerland, The ARTORG Center for Biomedical Engineering with Cendres+Métaux SA, Biel/Bienne, Switzerland

Robotic Cochlear Implantation

The ARTORG Center for Biomedical Engineering together with the Department of ENT, Head and Neck surgery (Inselspital) have developed a system for robotic cochlear implantation. The new approach enables to drill an access to the inner ear through a small tunnel (1.8 mm in diameter). Based on preoperative images, a safe drilling tunnel targeting the round window is planned and drilled by the robotic system. Intraoperatively the drill path is assessed using imaging and sensor-based data to confirm the proximity of the facial nerve. In summer 2016, the worldwide first robotic cochlear implantation was performed. The approach resulted in a minimal mastoidectomy and minimal incisions. The procedure was performed without complications and all surrounding structures were preserved demonstrating clinical feasibility of robotic cochlear implantation.

Pinna effect imitating directional microphones

Speech understanding in noise with a new cochlear implant processor (Med-El Sonnet) that uses a pinna effect imitating directional microphone system was evaluated in 10 subjects. All participants performed speech in noise tests with the older Opus 2 processor (omnidirectional microphone mode only) and the newer Sonnet processor (omnidirectional and directional microphone mode) in different noise settings. Speech intelligibility with the Sonnet system was statistically different to speech recognition with the Opus 2 system suggesting that CI users benefit from the pinna effect imitating directionality mode in noisy environments.

Zeitschrift Dezibel berichtet über roboterunterstützte Cochlea-Implantation

An den CI-Kliniken der Schweiz wird viel geforscht, um bessere Verfahren bei Cochlea-Implantat-Operationen zu entwickeln. An der Universitätsklinik für HNO am Berner Inselspital wurde ein neues roboterunterstütztes Bohrsystem. Beitrag_Dezibel_CochleaImplantation_pdf

Forschungsgruppe Hearing Research Laboratory

Das "ARTORG Center for Biomedical Engineering Research" der Universität Bern wurde 2008 gegründet mit dem Ziel technologische Forschung aus unterschiedlichen medizinischen Disziplinen in der Klinik umzusetzen. Die Gruppe "Hearing Research Laboratory" des ARTORG Center arbeitet in engster Kollaboration mit unserer Klinik und fokussiert auf Forschung implantierbarer Systeme im Bereich des Ohres. Artificial Hearing Research des ARTORG Center der Universität Bern