{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:40:32Z","timestamp":1787841632794,"version":"build-2784847793"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001665","name":"Agence Nationale de la Recherche","doi-asserted-by":"publisher","award":["ANR\u201023\u2010IAHU\u20100003"],"award-info":[{"award-number":["ANR\u201023\u2010IAHU\u20100003"]}],"id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To reduce operator\u2010dependent variability and improve surgical precision, robot\u2010assisted piston prosthesis placement and crimping during otosclerosis surgery may represent a promising approach. However, dedicated microsurgical forceps for this application are not yet available in clinical practice. This study aimed to assess the feasibility and precision of piston prosthesis placement and crimping, comparing manual and robot\u2010assisted techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A 3D\u2010printed temporal bone model was modified to measure forces applied to the incus. Robot\u2010assisted manipulation was performed using a robotic arm coupled with custom\u2010designed microforceps. Five otologists performed two tasks (piston placement and crimping) under three conditions: (1) manual under visual control, (2) robot\u2010assisted, both applied to placement and crimping, and (3) manual without visual feedback, applied to crimping only. This resulted in five procedures, each repeated three times (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915). Maximal force (N) and torque (N.mm) were recorded and compared using Mann\u2013Whitney and Kruskal\u2013Wallis tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Robot\u2010assisted piston placement resulted in lower maximal torque compared with the manual technique (4.2\u2009\u00b1\u20093.96 vs. 7.5\u2009\u00b1\u20094.73\u2009N.mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037), with no difference in maximal force. During crimping, robot\u2010assisted manipulation generated lower maximal force (0.15\u2009\u00b1\u20090.09 vs. 0.27\u2009\u00b1\u20090.09\u2009N,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0126) and lower maximal torque (6.1\u2009\u00b1\u20093.41 vs. 11.5\u2009\u00b1\u20093.09\u2009N.mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) than manual crimping. No difference was observed between manual crimping performed with and without visual control. Procedure duration was longer with robot\u2010assisted manipulation for both placement and crimping (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Robot\u2010assisted piston prosthesis placement and crimping were feasible and were associated with reduced mechanical loads applied to the incus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>5.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lio2.70485","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T07:34:18Z","timestamp":1782977658000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Manual Versus Robot\u2010Assisted Piston Prosthesis Placement and Crimping in a\n                    <scp>3D<\/scp>\n                    \u2010Printed Temporal Bone Model"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7826-0721","authenticated-orcid":false,"given":"Hannah","family":"Daoudi","sequence":"first","affiliation":[{"name":"AP\u2010HP, Inserm, CNRS, Fondation Pour L'audition, IHU reConnect, Technologies et Th\u00e9rapie G\u00e9nique Pour la Surdit\u00e9 Universit\u00e9 Paris Cit\u00e9, Institut Pasteur  Paris France"},{"name":"AP\u2010HP, GHU Piti\u00e9\u2010Salp\u00eatri\u00e8re, Service ORL et Implants Auditifs Sorbonne Universit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axelle","family":"Coban","sequence":"additional","affiliation":[{"name":"AP\u2010HP, Inserm, CNRS, Fondation Pour L'audition, IHU reConnect, Technologies et Th\u00e9rapie G\u00e9nique Pour la Surdit\u00e9 Universit\u00e9 Paris Cit\u00e9, Institut Pasteur  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato","family":"Torres","sequence":"additional","affiliation":[{"name":"AP\u2010HP, Inserm, CNRS, Fondation Pour L'audition, IHU reConnect, Technologies et Th\u00e9rapie G\u00e9nique Pour la Surdit\u00e9 Universit\u00e9 Paris Cit\u00e9, Institut Pasteur  Paris France"},{"name":"Service ORL et Chirurgie Maxillofaciale Centre Hospitalier Sud Francilien  \u00cele\u2010de\u2010France France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Resul","family":"Ekici","sequence":"additional","affiliation":[{"name":"Collin ORL  Bagneux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyne","family":"Ferrary","sequence":"additional","affiliation":[{"name":"AP\u2010HP, Inserm, CNRS, Fondation Pour L'audition, IHU reConnect, Technologies et Th\u00e9rapie G\u00e9nique Pour la Surdit\u00e9 Universit\u00e9 Paris Cit\u00e9, Institut Pasteur  Paris France"},{"name":"AP\u2010HP, GHU Piti\u00e9\u2010Salp\u00eatri\u00e8re, Service ORL et Implants Auditifs Sorbonne Universit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yann","family":"Nguyen","sequence":"additional","affiliation":[{"name":"AP\u2010HP, Inserm, CNRS, Fondation Pour L'audition, IHU reConnect, Technologies et Th\u00e9rapie G\u00e9nique Pour la Surdit\u00e9 Universit\u00e9 Paris Cit\u00e9, Institut Pasteur  Paris France"},{"name":"AP\u2010HP, GHU Piti\u00e9\u2010Salp\u00eatri\u00e8re, Service ORL et Implants Auditifs Sorbonne Universit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean C.","family":"Sheppard","sequence":"additional","affiliation":[{"name":"AP\u2010HP, Inserm, CNRS, Fondation Pour L'audition, IHU reConnect, Technologies et Th\u00e9rapie G\u00e9nique Pour la Surdit\u00e9 Universit\u00e9 Paris Cit\u00e9, Institut Pasteur  Paris 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