Development and Evaluation of a Reusable, Force Measuring Tool for the Robot-Assisted Insertion of Cochlear Implant Electrode Arrays.

Abstract

Limitations in human kinematics during cochlear implantation induce pressure transients and increased forces on intracochlear structures. Herein, we present a novel head-mounted surgical tool designed for the motorized insertion of cochlear implant electrode arrays. The tool integrates a force measurement feature to overcome the lack of haptic feedback in current robotic solutions. Utilizing a prototype device, we compare force measurements with those exerted on intracochlear structures in a realistic temporal bone model. Furthermore, we test the tool on six temporal bone specimens in a surgical setting to assess its performance in various anatomies. Force measurements exhibit good agreement with intracochlear forces, offering significantly improved resolution over manual, tactile sensing. Successful electrode array insertions in six cadaver specimens affirmed the feasibility of tool setup, motorized insertion and tool removal in different anatomies. The tool allows the robot-assisted insertion of cochlear implant electrode arrays and offers valuable insights during the surgical procedure, demonstrating promise for application in clinical contexts. This instrument has the potential to aid surgeons in achieving atraumatic placement of electrodes, consequently contributing to the improvement of hearing outcomes in cochlear implantation.