Evaluation of Insertion Forces and Cochlea Trauma Following Robotics-Assisted Cochlear Implant Electrode Array...

Area of Science:

• Otolaryngology
• Neurosurgery
• Biomedical Engineering

Background:

• Cochlear implant (CI) outcomes vary due to factors including surgical technique and insertion trauma.
• Previous research indicates that micromechanically controlled tools can decrease insertion forces and variability.
• Insertion trauma is a known contributor to the variability observed in CI patient outcomes.

Purpose of the Study:

• To evaluate the impact of cochlear implant (CI) electrode insertion technique on insertion forces and intracochlear trauma.
• To compare robotics-assisted insertion with manual insertion methods in terms of trauma and force.
• To test the hypothesis that robotics-assisted CI insertions reduce insertion forces and intracochlear trauma.

Main Methods:

• Electrode array insertions were performed manually (n=12) and with a robotics-assisted tool (n=12) in human cadaveric cochleae.
• Electrodes from four different CI manufacturers were used.
• High-resolution X-ray microscopy assessed electrode position and intracochlear trauma using a modified Eshraghi scale.

Main Results:

• Robotics-assisted insertions demonstrated significantly lower insertion forces and variability.
• Manual insertions resulted in a higher overall trauma score (3.1 ± 2.0) compared to robotics-assisted insertions (0.9 ± 1.0).
• Robotics-assisted insertions showed more basilar membrane elevations, while manual insertions had higher rates of severe trauma events.

Conclusions:

• The robotics-assisted insertion system effectively reduced trauma associated with CI electrode insertions in cadaveric models.
• Precise and consistent electrode insertion using surgical devices may lead to improved CI outcomes.
• This technology holds potential for enhancing hearing preservation in cochlear implant surgery.