Abstract
The insertion of the electrode array is a critical step in cochlear implantation. Herein we comprehensively investigate the impact of the alignment angle and feed-forward speed on deep insertions in artificial scala tympani models with accurate macro-anatomy and controlled frictional properties. Motorized insertions (n=1033) were performed in six scala tympani models with varying speeds and alignment angles. We evaluated reaction forces and micrographs of the insertion process and developed a mathematical model to estimate the normal force distribution along the electrode arrays. Insertions parallel to the cochlear base significantly reduce insertion energies and lead to smoother array movement. Non-constant insertion speeds allow to reduce insertion forces for a fixed total insertion time compared to a constant feed rate. In cochlear implantation, smoothness and peak forces can be reduced with alignment angles parallel to the scala tympani centerline and with non-constant feed-forward speed profiles. Our results may help to provide clinical guidelines and improve surgical tools for manual and automated cochlear implantation.
Highlights
A TRAUMATIC insertion of the electrode array into the scala tympani is not always achieved in cochlear implantation
Even with respect to conventional cochlear implantation, our results suggest that the electrode array should be aligned with the goal of minimizing the mediolateral angle, in order to decrease insertion forces
We used scala tympani models with accurate macro-anatomy and controlled frictional properties to analyze the impact of insertion speed and angle of approach on reaction forces, the smoothness of motion and the array curvature for deep insertions of lateral wall electrode arrays
Summary
A TRAUMATIC insertion of the electrode array into the scala tympani is not always achieved in cochlear implantation.
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