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Robotic Cochlear Implantation for Direct Cochlear Access
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Development and Characterization of an Electrocochleography-Guided Robotics-Assisted Cochlear Implant Array Insertion

Allan M Henslee1, Christopher R Kaufmann1, Matt D Andrick1

  • 1iotaMotion, Inc, Iowa City, Iowa, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|October 5, 2021
PubMed
Summary

A new robotic system guides cochlear implant (CI) insertion using electrocochleography (ECochG) to prevent hearing loss. This ECochG-guided system detects trauma in real-time and adjusts insertion, potentially improving patient outcomes.

Keywords:
cochlear implant insertionelectrocochleographyrobotics assisted

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Area of Science:

  • Biomedical Engineering
  • Neurosurgery
  • Audiology

Background:

  • Cochlear implant (CI) surgery aims to restore hearing but carries risks of intracochlear trauma.
  • Electrocochleography (ECochG) monitoring during CI insertion can detect trauma, as signal drops correlate with poorer hearing outcomes.
  • Current manual insertion techniques may not consistently prevent insertion-related trauma.

Purpose of the Study:

  • To develop and characterize an ECochG-guided robotics-assisted system for CI electrode array insertion.
  • To evaluate the system's ability to monitor real-time ECochG signals and adapt insertion parameters.
  • To assess the potential of this system in reducing intracochlear trauma and improving hearing outcomes.

Main Methods:

  • A proof-of-concept study involved benchtop evaluation of simulated ECochG signal changes and robotic adaptation.
  • A pilot in vivo sheep study characterized ECochG signal-to-noise ratio and amplitude during robotic insertion.
  • The system integrates an insertion drive unit, an ECochG recording module, and a surgeon-controlled console.

Main Results:

  • The system demonstrated microvolt signal resolution and a response time under 100 milliseconds, faster than human response.
  • Benchtop tests confirmed the system's ability to detect simulated ECochG changes and adapt insertion.
  • In vivo sheep studies showed high signal-to-noise ratio and sufficient amplitude for ECochG recordings during robotic insertion.

Conclusions:

  • An ECochG-guided robotics-assisted CI insertion system can detect real-time ECochG signal drops and modify insertion motion.
  • This technology offers a potential method for surgeons to monitor and mitigate CI insertion trauma.
  • The system may lead to improved hearing outcomes in cochlear implant recipients by reducing surgical trauma.