An automated insertion tool for cochlear implants: another step towards atraumatic cochlear implant surgery

Abstract

The automated insertion tool has proven its capability to perform electrode insertions with final insertion depth angles within the target range of a standard cochlear implant surgery. Additionally, to the knowledge of the authors, it represents the only possibility to automatically insert cochlear implant electrodes via minimally invasive approaches.

Cone Beam and Micro-Computed Tomography Validation of Manual Array Insertion for Minimally Invasive Cochlear Implantation

“…As opposed to electrode array insertion through conventional mastoidectomy under direct visual feedback using standardized insertion tools, insertion through small tunnel holes is more demanding due to restricted access for visual inspection and maneuvering of the electrode array. Thus, specific insertion tools, for both automatic and manual insertion, have been proposed [Hussong et al, 2010;Kratchman et al, 2012]. However, to our knowledge, no clinical data have been published on the effectiveness of such insertion tools.…”

Inroads Toward Robot-Assisted Cochlear Implant Surgery Using Steerable Electrode Arrays

“…In 2009, another robotic insertion tool specialized for Contour Advance electrode was introduced (23) but did not incorporate any force-sensing capability on the tool. The limitations of these prototypes include the following: only working with a special kind of electrodes (23), limited degrees of freedom (DoF) (23), and not applicable to real surgical procedures (21).…”

Determination of the curling behavior of a preformed cochlear implant electrode array

“…It is obvious to apply these technologies also for an accurate insertion of the implant by taking into account the helical shape of the cochlea and adapting the electrode's coiling behavior to it. The automated insertion tool, as described in detail in previous publications [33][34][35][36], offers the necessary technical prerequisite.…”

“…The same goal was successfully achieved by using image-guided surgical systems [21][22][23] as well as a robot assistance device [24][25][26][27]. Due to the geometrical limitations of a drill hole, the minimally invasive approach requires the development of a special insertion tool as presented by our group [33][34][35][36]. This tool can be tracked by the image-guiding system or, alternatively, be positioned by the robot assistant device to compensate for the missing visual control during the insertion process.…”