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An Optimized Robot-Based Technique for Cochlear Implantation to Reduce Array Insertion Trauma.

Renato Torres1,2, Huan Jia1,3, Mylène Drouillard1,2

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Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
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PubMed
Summary
This summary is machine-generated.

Optimized robot-based insertion reduced intracochlear trauma compared to manual techniques. This approach, using a robot arm and motorized tool, improves electrode placement accuracy in cochlear implant electrode array insertion.

Keywords:
anatomy and histologycochleacone-beam computed tomographyneuronavigationroboticsscala tympaniscala vestibulitemporal bonestomography scanners

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Area of Science:

  • Otolaryngology
  • Medical Robotics
  • Biomedical Engineering

Background:

  • Cochlear implantation is a complex procedure requiring precise electrode array insertion.
  • Minimizing intracochlear trauma is crucial for optimal hearing outcomes.
  • Current manual insertion techniques may lead to variable outcomes and potential trauma.

Purpose of the Study:

  • To compare intracochlear trauma between optimized robot-based and manual insertion techniques for a straight electrode array prototype.
  • To evaluate the impact of different insertion lengths (21 mm and 25 mm) on trauma and electrode placement.

Main Methods:

  • An experimental study using 20 temporal bones.
  • Insertion of a prototype electrode array at 21 mm and 25 mm lengths.
  • Comparison of manual insertion (microforceps) with an optimized robot-based approach (robot arm, tracking system, motorized insertion tool at 0.25 mm/s).
  • Stereomicroscopic cochlea section analysis to determine electrode position.

Main Results:

  • The optimized robot-based approach resulted in a higher number of electrodes correctly located in the scala tympani (P = .03).
  • Insertion at 25 mm, regardless of technique, ensured complete insertion of the active stimulating portion.
  • The optimized insertion technique was associated with significantly less intracochlear trauma than manual insertion (P = .04).

Conclusions:

  • Robot-based insertion, utilizing an optimal axis, motorized insertion, and constant speed, can reduce intracochlear trauma compared to manual methods.
  • Optimized robotic assistance offers potential for improved safety and efficacy in cochlear implant surgery.