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

verfasst von

Georg Böttcher-Rebmann, Viktor Schell, Leon Budde, M. Geraldine Zuniga, Claas Baier, Thomas Lenarz, Thomas Stephan Rau

Abstract

Objective: Residual hearing preservation during cochlear implant (CI) surgery is closely linked to the magnitude of intracochlear forces acting during the insertion process. So far, these forces have only been measured <italic>in vitro</italic>. Therefore, the range of insertion forces and the magnitude of damage-inducing thresholds in the human cochlea <italic>in vivo</italic> remain unknown. We aimed to develop a method to intraoperatively measure insertion forces without negatively affecting the established surgical workflow. Initial experiments showed that this requires the compensation of orientation-dependent gravitational forces. <italic>Methods:</italic> We devised design requirements for a force-sensing manual insertion tool. Experienced CI surgeons evaluated the proposed design for surgical safety and handling quality. Measured forces from automated and manual insertions into an artificial cochlea model were evaluated against data from a static external force sensor representing the gold standard. <italic>Results:</italic> The finalized manual insertion tool uses an embedded force sensor and inertial measurement unit to measure insertion forces. The evaluation of the proposed design shows the feasibility of orientation-independent insertion force measurements. Recorded forces correspond well to externally recorded reference forces after reliable removal of gravitational disturbances. CI surgeons successfully used the tool to insert electrode arrays into human cadaver cochleae. <italic>Conclusion:</italic> The presented positive evaluation poses the first step towards intraoperative use of the proposed tool. Further <italic>in vitro</italic> experiments with human specimens will ensure reliable <italic>in vivo</italic> measurements. <italic>Significance:</italic> Intraoperative insertion force measurements enabled by this tool will provide insights on the relationship between forces and hearing outcomes in cochlear implant surgery.

Organisationseinheit(en)

Institut für Mechatronische Systeme

Externe Organisation(en)

Medizinische Hochschule Hannover (MHH)

Typ

Artikel

Journal

IEEE Transactions on Biomedical Engineering

Band

70

Seiten

1643-1650

Anzahl der Seiten

8

ISSN

0018-9294

Publikationsdatum

24.11.2022

Publikationsstatus

Veröffentlicht

Peer-reviewed

Ja

ASJC Scopus Sachgebiete

Biomedizintechnik

Elektronische Version(en)

https://doi.org/10.1109/tbme.2022.3224528 (Zugang: Offen)