Combining Intraoperative Electrocochleography with Robotics-Assisted Electrode Array Insertion

Kashani, Rustin G.; Kocharyan, Armine; Bennion, Douglas M.; Scheperle, Rachel A.; Etler, Christine; Oleson, Jacob; Dunn, Camille C.; Claussen, Alexander D.; Gantz, Bruce J.; Hansen, Marlan R.

doi:10.1097/mao.0000000000004094

Cited by 2 publications

(1 citation statement)

References 52 publications

(65 reference statements)

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“…Instead, they showed the growth functions of the amplitude of ECochG, ECochG responses recorded from a single location before and after insertion, or ECochG thresholds for different stimuli, amongst others. The remaining 74 studies [ 9 , 10 , 11 , 12 , 13 , 15 , 17 , 18 , 19 , 20 , 21 , 24 , 25 , 34 , 35 , 37 , 39 , 40 , 41 , 42 , 48 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 ...…”

Section: Resultsmentioning

confidence: 99%

ZH-ECochG Bode Plot: A Novel Approach to Visualize Electrocochleographic Data in Cochlear Implant Users

Geys,

Sijgers,

Dobrev

et al. 2024

JCM

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Background: Various representations exist in the literature to visualize electrocochleography (ECochG) recordings along the basilar membrane (BM). This lack of generalization complicates comparisons within and between cochlear implant (CI) users, as well as between publications. This study synthesized the visual representations available in the literature via a systematic review and provides a novel approach to visualize ECochG data in CI users. Methods: A systematic review was conducted within PubMed and EMBASE to evaluate studies investigating ECochG and CI. Figures that visualized ECochG responses were selected and analyzed. A novel visualization of individual ECochG data, the ZH-ECochG Bode plot (ZH = Zurich), was devised, and the recordings from three CI recipients were used to demonstrate and assess the new framework. Results: Within the database search, 74 articles with a total of 115 figures met the inclusion criteria. Analysis revealed various types of representations using different axes; their advantages were incorporated into the novel visualization framework. The ZH-ECochG Bode plot visualizes the amplitude and phase of the ECochG recordings along the different tonotopic regions and angular insertion depths of the recording sites. The graph includes the pre- and postoperative audiograms to enable a comparison of ECochG responses with the audiometric profile, and allows different measurements to be shown in the same graph. Conclusions: The ZH-ECochG Bode plot provides a generalized visual representation of ECochG data, using well-defined axes. This will facilitate the investigation of the complex ECochG potentials generated along the BM and allows for better comparisons of ECochG recordings within and among CI users and publications. The scripts used to construct the ZH-ECochG Bode plot are provided by the authors.

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Section: Resultsmentioning

confidence: 99%

ZH-ECochG Bode Plot: A Novel Approach to Visualize Electrocochleographic Data in Cochlear Implant Users

Geys,

Sijgers,

Dobrev

et al. 2024

JCM

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Quantitative in-vitro assessment of a novel robot-assisted system for cochlear implant electrode insertion

Aebischer,

Anschuetz,

Caversaccio

et al. 2024

Int J CARS

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Purpose As an increasing number of cochlear implant candidates exhibit residual inner ear function, hearing preservation strategies during implant insertion are gaining importance. Manual implantation is known to induce traumatic force and pressure peaks. In this study, we use a validated in-vitro model to comprehensively evaluate a novel surgical tool that addresses these challenges through motorized movement of a forceps. Methods Using lateral wall electrodes, we examined two subgroups of insertions: 30 insertions were performed manually by experienced surgeons, and another 30 insertions were conducted with a robot-assisted system under the same surgeons’ supervision. We utilized a realistic, validated model of the temporal bone. This model accurately reproduces intracochlear frictional conditions and allows for the synchronous recording of forces on intracochlear structures, intracochlear pressure, and the position and deformation of the electrode array within the scala tympani. Results We identified a significant reduction in force variation during robot-assisted insertions compared to the conventional procedure, with average values of 12 mN/s and 32 mN/s, respectively. Robotic assistance was also associated with a significant reduction of strong pressure peaks and a 17 dB reduction in intracochlear pressure levels. Furthermore, our study highlights that the release of the insertion tool represents a critical phase requiring surgical training. Conclusion Robotic assistance demonstrated more consistent insertion speeds compared to manual techniques. Its use can significantly reduce factors associated with intracochlear trauma, highlighting its potential for improved hearing preservation. Finally, the system does not mitigate the impact of subsequent surgical steps like electrode cable routing and cochlear access sealing, pointing to areas in need of further research.

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Combining Intraoperative Electrocochleography with Robotics-Assisted Electrode Array Insertion

Cited by 2 publications

References 52 publications

ZH-ECochG Bode Plot: A Novel Approach to Visualize Electrocochleographic Data in Cochlear Implant Users

ZH-ECochG Bode Plot: A Novel Approach to Visualize Electrocochleographic Data in Cochlear Implant Users

Quantitative in-vitro assessment of a novel robot-assisted system for cochlear implant electrode insertion

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