Feasibility of the set-up for the different approaches in robotic head and neck surgery with the Versius Surgical System.

The Versius Surgical System is a next generation soft-tissue robot with instrument and endoscope arms split into individual modules. Despite its similarities with previous systems, the basic changes in the design raise concerns relating to the feasibility of the set-up for the different approaches in robotic head and neck surgery procedures. We used a complete unit with a surgeon's console and four modules on a training mannequin to depict the different configurations in the operating room. We tested transoral robotic surgery and the four basic configurations for the remote access to the neck: transoral/transvestibular, retroauricular, axillary and bilateral axillo-breast approaches. We obtained a high quality simulation for transoral robotic surgery, as well as for the usual remote access approaches, except for the axillary approach. We were able to obtain an optimal distribution of the modules around the surgical table and an adequate configuration of the joints allowing the instruments to reach their targets. The Versius Surgical System might be an alternative device for robotic procedures in head and neck surgery, although this needs to be proved in a clinical setting.

[Quality of life of patients with BAHA]. / Calidad de vida de los pacientes con BAHA.

OBJECTIVE: The aim of this study is to quantify changes in quality of life due to the use of BAHA. PATIENTS AND METHOD: Twenty-eight patients were included. The instrument used to quantify the change in quality of life was the Glasgow Benefit Inventory and a questionnaire including 2 open questions, BAHA use, change in tinnitus, and postoperative pain. RESULTS: The average total benefit score with the Glasgow Benefit Inventory was 38, and the general, social, and physical score were 54, 10, and 1, respectively. There was no significant association between preoperative hearing, aetiology or type of hearing loss, and quality of life. Tinnitus rate went from 37.5% to 20.8% following BAHA; this difference being significant. CONCLUSIONS: Our results show that the use of BAHA is associated with a great improvement in quality of life. Also, they show that its use has a positive effect upon tinnitus.

[Quality of life in patients implanted with the BAHA device depending on the aetiology]. / Calidad de vida de pacientes implantados con el dispositivo BAHA según su indicación.

INTRODUCTION AND OBJECTIVES: Assess the improvement of quality of life in osseointegrated implanted patients, taking into account the indication as well as the use of the implant, and the presence of pre- and postoperative tinnitus. METHODS: Sixty-nine patients implanted between June 2004 and November 2010 were included. The average age of the patients was 40 years. The instruments used to quantify the change in quality of life were the Glasgow Benefit Inventory and a questionnaire including open questions, bone anchored hearing aid (BAHA) use, change in tinnitus and postoperative pain. RESULTS: The average total benefit score with the Glasgow Benefit Inventory was 38, and the general, social, and physical scores were 51, 15 and 7, respectively. There was no significant association between sex, age and bilaterality or unilaterality of the process with quality of life. Nevertheless, there were significantly better results in patients with conductive hearing loss than in those with unilateral deafness, the results were positive although in both groups. The tinnitus rate went from 37.5 to 20.8% following BAHA, with this difference being significant. CONCLUSIONS: Our results show that the use of BAHA is associated with a great improvement in quality of life for patients with conductive hearing loss, whereas indications in unilateral deafness have to be individually studied. Moreover, the study shows that BAHA has a positive effect upon tinnitus.

Calidad de vida de pacientes implantados con el dispositivo BAHA según su indicación / Quality of life in patients implanted with the BAHA device depending on the aetiology

Introducción y objetivos: Cuantificar la mejoría en la calidad de vida en los pacientes osteoimplantados, teniendo en consideración tanto la indicación del implante como su uso y la presencia de acúfenos. Métodos: Este estudio incluye a 69 pacientes implantados entre junio de 2004 y noviembre de 2010. La edad media de los pacientes fue de 40 años. El instrumento empleado para la medición de la calidad de vida fue el Glasgow Benefit Inventory (GBI) y un cuestionario con preguntas abiertas, uso del BAHA, modificación del acúfeno y presencia o no de dolor. Resultados: La puntuación media del GBI total fue de 38, y en las subescalas general, social y física: 51, 15 y 7 respectivamente. La media de horas al día de utilización fue de 11. No se encontró relación significativa entre el sexo, edad y bilateralidad o unilateralidad del proceso con la calidad de vida. En cambio se observaron diferencias significativas entre los pacientes con hipoacusia transmisiva y con cofosis unilateral, si bien en ambos grupos los resultados fueron positivos. La presencia de acúfeno disminuyó de un 37,5 a un 20,8%, siendo esta diferencia estadísticamente significativa. Conclusiones: Nuestros resultados muestran que el uso del BAHA se asocia a una clara mejoría en la calidad de vida de los pacientes, menor en cofosis unilaterales, siendo necesario individualizar su indicación en este grupo. Asimismo muestran que el uso del BAHA tiene un efecto beneficioso sobre el acúfeno (AU)

Introduction and objectives: Assess the improvement of quality of life in osseointegrated implanted patients, taking into account the indication as well as the use of the implant, and the presence of pre- and postoperative tinnitus. Methods: Sixty-nine patients implanted between June 2004 and November 2010 were included. The average age of the patients was 40 years. The instruments used to quantify the change in quality of life were the Glasgow Benefit Inventory and a questionnaire including open questions, bone anchored hearing aid (BAHA) use, change in tinnitus and postoperative pain. Results: The average total benefit score with the Glasgow Benefit Inventory was 38, and the general, social, and physical scores were 51, 15 and 7, respectively. There was no significant association between sex, age and bilaterality or unilaterality of the process with quality of life. Nevertheless, there were significantly better results in patients with conductive hearing loss than in those with unilateral deafness, the results were positive although in both groups. The tinnitus rate went from 37.5 to 20.8% following BAHA, with this difference being significant. Conclusions: Our results show that the use of BAHA is associated with a great improvement in quality of life for patients with conductive hearing loss, whereas indications in unilateral deafness have to be individually studied. Moreover, the study shows that BAHA has a positive effect upon tinnitus (AU)

Calidad de vida de los pacientes con BAHA / Quality of life of patients with BAHA

Objetivo: El objetivo de este estudio es cuantificar los cambios en la calidad de vida en los pacientes con implantes osteointegrados (BAHA). Pacientes y método: Se incluyó a 28 pacientes. El instrumento empleado para medir la calidad de vida fue el Glasgow Benefit Inventory y un cuestionario con 2 preguntas abiertas, uso del BAHA, modificación de los acufenos y dolor postoperatorio. Resultados: La puntuación media del Glasgow Benefit Inventory total fue 38, y en las subescalas general, social y física, 54, 10 y 1, respectivamente. No se encontró relación significativa entre el grado de audición preoperatorio, la etiología o el tipo de hipoacusia y la calidad de vida. La tasa de acufenos disminuyó del 37,5 al 20,8 % tras la colocación del BAHA, con diferencias significativas. Conclusiones: Nuestros resultados muestran que el uso del BAHA se asocia a una gran mejoría en la calidad de vida. Asimismo, muestran que su uso tiene un efecto positivo en los acufenos

Objective: The aim of this study is to quantify changes in quality of life due to the use of BAHA. Patients and method: Twenty-eight patients were included. The instrument used to quantify the change in quality of life was the Glasgow Benefit Inventory and a questionnaire including 2 open questions, BAHA use, change in tinnitus, and postoperative pain. Results: The average total benefit score with the Glasgow Benefit Inventory was 38, and the general, social, and physical score were 54, 10, and 1, respectively. There was no significant association between preoperative hearing, aetiology or type of hearing loss, and quality of life. Tinnitus rate went from 37.5 % to 20.8 % following BAHA; this difference being significant. Conclusions: Our results show that the use of BAHA is associated with a great improvement in quality of life. Also, they show that its use has a positive effect upon tinnitus