A Tool to Enable Intraoperative Insertion Force Measurements for Cochlear Implant Surgery

Area of Science:

• Biomedical Engineering
• Otolaryngology
• Surgical Technology

Background:

• Residual hearing preservation in cochlear implant (CI) surgery is critical.
• Intracochlear forces during insertion impact hearing outcomes.
• Current methods lack in vivo intraoperative force measurement capabilities.

Purpose of the Study:

• To develop a method for intraoperative measurement of insertion forces during CI surgery.
• To create a force-sensing manual insertion tool that integrates into the surgical workflow.
• To enable real-time monitoring of forces to potentially prevent cochlear damage.

Main Methods:

• Designed a force-sensing manual insertion tool with an embedded force sensor and inertial measurement unit.
• Evaluated the tool's design for surgical safety and handling by experienced CI surgeons.
• Validated force measurements against a gold standard external sensor using artificial cochlea models and human cadavers.

Main Results:

• The developed tool enables orientation-independent insertion force measurements.
• Recorded forces closely matched reference data after compensating for gravitational effects.
• CI surgeons successfully utilized the tool for electrode array insertion in human cadaveric cochleae.

Conclusions:

• The study presents a feasible method for intraoperative insertion force measurement in CI surgery.
• This technology is a significant step towards real-time monitoring and improved surgical precision.
• Further in vitro testing with human specimens is planned to validate in vivo measurements.