In recent years, medicine has made some remarkable advances – for example, in the field of computer-assisted surgery. In the field of ear, nose and throat medicine, too, there are specialists who make use of this state-of-the-art technology: Prof. Dr Marco Domenico Caversaccio, who specializes in particularly complex tumors of the head and neck at Inselspital Bern, has already been able to restore hearing to many deaf patients. He explained in detail to the Leading Medicine Guide what this involves.
As Clinic Director and Chief Physician, Prof. Caversaccio heads the University Clinic for ENT, Head and Neck Surgery at Inselspital; he is also Deputy Director of the ARTORG Center for Biomedical Research at the University of Bern. This internationally renowned center offers a glimpse into what the ENT specialist has been working on intensively for some time. For at the ARTORG Center – just as at the Inselspital – the course is being set for the future. Experiments with artificial intelligence are being conducted there. No wonder, then, that Prof. Caversaccio utilizes the latest robotic technology. What’s more: thanks to his early focus on technical development, he has long possessed a wealth of experience. He has also set standards from the very beginning when it comes to particularly innovative robotic technology in the field of ENT.
Leading Medicine Guide: Professor Caversaccio, did you realize early on that the ENT field in particular benefits so enormously from supportive robotic technology?
Prof. Dr. med. Caversaccio: That is obvious, precisely because we ENT doctors deal with the smallest bones in the human body and because we are required to possess tremendous manual dexterity in any case. We are dealing here with vital sensory organs – and because it is primarily the ability to hear that enables people to participate in social life. Until recently, those who had lost this ability had little hope that their condition would ever change. But as medicine is making such enormous progress, different standards apply today: we have already frequently succeeded in restoring the ability to hear to deaf people – and in such a way that they can lead a social life with virtually no disruption.
Leading Medicine Guide: How would you describe the success rate?
Prof. Dr. med. Caversaccio: Certainly, ‘Dr Robot’ doesn’t always succeed either. But if it is conceivable to compensate for hearing loss, even up to complete deafness, then we leave no stone unturned. To do this, we rely on state-of-the-art, completely newly developed hearing aids – for example, cochlear implants that can be successfully inserted into the ear. Older patients in particular, who have become almost deaf due to illness, can suddenly rejoice in their regained hearing.
Leading Medicine Guide: But how exactly does the robot work, in which so many patients place such high hopes?
Prof. Dr. med. Caversaccio: Well, the path to the cochlea – that is, the inner ear – is very narrow. To reach the target with precision along this narrow path into the inner ear, you need not only tremendous dexterity and a hand that is far more steady than average, but also the appropriate technology to pave the way there. This allows us – with technical assistance – to insert the electrode unerringly at the entrance to the cochlea. The idea of using implants to compensate for hearing loss is by no means new. The first implants were inserted into the ear as early as the 1980s. However, these had to take a roundabout route, for example via the skull bone. And that was always associated with a high risk.
Leading Medicine Guide: So things have changed a great deal in just a few decades. How exactly?
Prof. Dr. med. Caversaccio: With the help of the robot, a channel less than two millimeters wide is drilled, which passes by the gustatory and facial nerves and extends to the entrance of the cochlea. The implant is then inserted at the end of this tunnel, which transmits the precisely calculated electronic signals to the cochlea. The results never cease to amaze even us.
Leading Medicine Guide: Has the development already been completed, or are there still new goals?
Prof. Dr. med. Caversaccio: The number of cochlear implants I have inserted so far is now in the hundreds. My aim is to eventually be able to perform outpatient procedures with the help of ‘Dr Robot’. Then patients who have been treated in the morning could leave the clinic again by the evening. With one crucial difference: they can hear!
Professor Caversaccio, thank you for the interesting conversation!
Word of this renowned specialist’s expertise has, of course, now spread far and wide. As a result, patients from all over the world come to Bern to benefit from the professor’s expertise. This expertise extends far beyond implants and tumor operations on the head and neck – and also includes, for example, laryngeal surgery, where the utmost care is taken to preserve the voice and thus the ability to speak. Here too, Prof. Dr. med. Marco Domenico Caversaccio relies on the support that has made him renowned in professional circles: computer-assisted procedures. Do you have any questions or would you like to contact the doctor directly? Then visit his profile page on the Leading Medicine Guide expert portal!
