First clinical implementation of insertion force measurement in cochlear implantation surgery

Area of Science:

• Biomedical Engineering
• Neurosurgery
• Audiology

Background:

• Minimizing insertion trauma during cochlear implant (CI) surgery is crucial for preserving residual hearing.
• Current methods for assessing insertion forces lack precision, relying on limited haptic feedback.
• There is a need for objective, real-time measurement of forces during electrode array (EA) insertion.

Purpose of the Study:

• To develop and evaluate a novel force-sensitive insertion tool for real-time measurement of forces during CI surgery.
• To assess the feasibility and practicability of using this tool in a clinical setting.
• To establish a foundation for future research into insertion trauma and prevention strategies.

Main Methods:

• Development of a force-sensitive insertion tool for capturing intraoperative forces.
• Integration of the tool into standard cochlear implant surgical procedures.
• Evaluation of initial clinical data from five patients, including force profiles from four.

Main Results:

• The force-sensitive tool was successfully integrated into the surgical workflow.
• In vivo insertion force measurement was demonstrated as feasible and practical.
• Recorded in vivo insertion forces ranged from 17.2–43.6 mN at the end of insertion, with peak forces between 44.8–102.4 mN.

Conclusions:

• The developed tool shows promise for assisting surgeons in monitoring and potentially minimizing insertion forces.
• This technology can contribute to reducing insertion trauma and improving the preservation of residual hearing.
• Continued data collection will support research into the causes of insertion trauma and the development of new prevention methods.