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Anterior clinoidectomy is a surgical procedure used to access the central skull base, providing access to sellar and parasellar pathologies and vascular lesions in and around the cavernous sinus. However, the procedure is challenging and risky due to limited working space, restricted surgical view, and proximity to critical anatomical structures such as the carotid artery, oculomotor nerve, and optic nerve.

The surgical procedure known as optic nerve unroofing plays a vital role in skull base surgery. This critical intervention focuses on relieving pressure and decompressing the optic nerve to safeguard vision, restore optimal nerve function, and enhance the surgical view during aneurysm therapy. Nevertheless, the surgical procedure presents inherent challenges and risks due to factors like limited working space, restricted surgical view, and the proximity to critical anatomical structures, including the optic nerve, carotid artery and oculomotor nerve. Significant advancements in medical robotics technology hold promise for addressing these challenges and potentially enhancing multiple aspects of neurosurgery. The objective of this study was to evaluate the feasibility and precision of utilizing CARLO© (Cold Ablation Roboterguided Laser Osteotome) for delineating the boundaries of the optical canal. Additionally, the investigation involved the insertion of a thermal probe into the optical canal to assess the occurrence of significant heat damage resulting from the removal of the optic roof. Success was defined as the accurate excavation of the optical canal, which was confirmed through post-experimental CT scans and photographic documentation. The experiment utilized five fresh frozen skulls, securely fixed in a Mayfield clamp to ensure a stable experimental setup. Prior to the procedure, preoperative planning was conducted using NeuroPlan©, which accurately segmented crucial anatomical structures and devised trajectories with a safety margin of 2mm from high-risk areas. A navigation system and additional referencing screws were employed to achieve precise bone ablation. The target structure was accessed through a pterional craniotomy and the optical canal was prepared extradurally. While data evaluation is ongoing, preliminary results indicate a successful delineation of the optical roof without significant heat damage while preserving vital anatomical structures. These initial findings have the potential to stimulate further investigation into the applications of robotic and laser technologies in the realm of neurosurgery. The study emphasizes the feasibility and exceptional precision of robotic technology, which can be utilized to advance the development of additional procedures to improve patient outcomes and reduce perioperative risks in neurosurgical interventions.

Brain biopsies are necessary in cases of unclear lesions on imaging studies to establish a treatment plan based on the histologic diagnosis. A previous study investigated the potential of lasers to make brain biopsies less invasive, faster and safer. The study demonstrated that lasers can create highly precise burr holes which themselves can act as a sufficient guide for the biopsy needle. Furthermore, lasers can create tangential canals in the bone which allows to biopsy brain regions that are usually impossible or hazardous to access. Building upon the results of the previous study, further research and technological advancements were pursued. This includes a biopsy needle attachment for the robot, which will be used to simulate brain biopsies using CARLO© (Cold Ablation Robot-guided Laser Osteotome) with its Er:YAG laser and navigated robotic guiding system. The study utilizes five freshly frozen skulls, which are immobilized using a Mayfield clamp. Prior to conducting the experiment, the NeuroPlan© software is employed to plan the path and angle of the biopsies. To align the preexperimental CT with the skull, referencing points on the skull and its surface are registered using a pointer. A small skin incision is performed to reach the area of bone where the laser ablates the bone for the biopsy. Preliminary experimental results suggest that the combined use of laser ablation and a guidance device enables precise bone ablation and accurate needle guidance for biopsies. These initial results demonstrate the potential of integrating laser technology and robotics in neurosurgery, potentially enabling less invasive, faster and safer biopsies, ultimately leading to better patient outcomes.

During the development of reading skills in primary school, children begin to make guesses about unfamiliar words when reading a text. This process of lexical inference is an important source of new vocabulary acquisition. In the present study, 55 children with a wide range of reading skills and vocabulary knowledge were asked to infer the meaning of unknown words (i.e., pseudowords) inserted into a short story and to provide insight into their inferencing processes. The results show that children use a variety of cues. While learners with higher reading skills and vocabulary knowledge tend to be more successful inferencers and rely more on contextual cues, the evidence for the use of phonological cues is limited. Furthermore, in 20 percent of the cases, children were able to recall the meaning of a pseudoword already mentioned in the text.