Robotics, automation, active electrode arrays, and new devices for cochlear implantation: A contemporary review

Seta, Daniele De; Daoudi, Hannah; Torres, Renato; Ferrary, Évelyne; Sterkers, Olivier; Nguyen, Yann

doi:10.1016/j.heares.2021.108425

Cited by 20 publications

(16 citation statements)

References 118 publications

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“…Appropriate cooling strategies may even allow significantly lower insertion speeds as aimed for in robot assisted insertions. 20,[29][30][31][32] However, investigating this would require a test stand with automated insertion, which falls outside the scope of this study.…”

Section: Discussionmentioning

confidence: 99%

“…This should also include further investigation of the cooling, including research questions such as whether less cooled conditions are sufficient; for example by combining milder local hypothermia with under water insertion. Appropriate cooling strategies may even allow significantly lower insertion speeds as aimed for in robot assisted insertions 20,29–32 . However, investigating this would require a test stand with automated insertion, which falls outside the scope of this study.…”

Section: Discussionmentioning

confidence: 99%

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Toward a cochlear implant electrode array with shape memory effect for post‐insertion perimodiolar positioning

et al. 2022

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For cochlear implants (CI) a final position of the electrode array (EA) along the inner wall of the spirally shaped cochlea is considered to be beneficial because it results in a closer proximity to the auditory nerve fibers. A shape memory effect (SME) could facilitate such shift of the EA toward the cochlear inner wall, but its implementation remains to be solved. The current study presents an EA prototype featuring the SME with minute adjustments of the material properties of Nitinol, a shape memory alloy, in combination with a suitable cooling strategy to prevent premature curling. Ten samples were successfully inserted by a CI surgeon into an artificial cochlear model submerged into a temperature‐controllable water bath to simulate temporary hypothermia of the inner ear (31°C). Gentle insertions were possible, with an average insertion speed of 0.81 ± 0.14 mm/s. After recovery of body temperature, the desired position shift toward the modiolus was observed in all trials. Angular insertion depth increased by approximately 81.8° ± 23.4°. We demonstrate for the first time that using the body temperature responsive SME for perimodiolar EA positioning is feasible and does not impede a gentle surgical insertion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Toward a cochlear implant electrode array with shape memory effect for post‐insertion perimodiolar positioning

et al. 2022

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“…Variability in patient temporal and cochlear anatomy, as well as surgeon technique [48], may affect hearing preservation outcomes, and robotics are viewed as a potentially promising venue of minimizing these variabilities [49 ▪▪ ].…”

Section: Robotic Systems For Minimally Invasive Cochlear Implantation...mentioning

confidence: 99%

Robotics and cochlear implant surgery: goals and developments

Shoman

2022

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of reviewCochlear implantation (CI) is a viable option for patients with severe sensorineural hearing loss. Advances in CI have focused on minimizing cochlear trauma to improve hearing preservation outcomes, and in doing so expanding candidacy to patients with useful cochlear reserve. Robotics holds promise as a potential tool to minimize intracochlear trauma with electrode insertion, improve surgical efficiency, and reduce surgical complications. The purpose of this review is to summarize efforts and advances in the field of robotic-assisted CI. Recent findingsWork on robotics and CI over the past few decades has explored distinct surgical aspects, including image-based surgical planning and intraoperative guidance, minimally invasive robotic-assisted approaches mainly through percutaneous keyhole direct cochlear access, robotic electrode insertion systems, robotic manipulators, and drilling feedback control through end effector sensors. Feasibility and safety have been established and many devices are undergoing clinical trials for clinical adoption, with some having already achieved approval of national licensing bodies. Summary:Significant work has been done over the past two decades that has shown robotic-assisted CI to be feasible and safe. Wider clinical adoption can potentially result in improved hearing preservation and quality of life outcomes to more CI candidates.

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“…Robot-assisted cochlear implantation is the result of over a decade of research & development work but is still in its childhood era [ 9 , 10 ]. Successful hearing rehabilitation with a CI is a complex, multi-stage process.…”

Section: Introductionmentioning

confidence: 99%

Robot-Assisted Electrode Insertion in Cochlear Implantation Controlled by Intraoperative Electrocochleography—A Pilot Study

Gawęcki

Balcerowiak

Podlawska

et al. 2022

JCM

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Robotics in otology has been developing in many directions for more than two decades. Current clinical trials focus on more accurate stapes surgery, minimally invasive access to the cochlea and less traumatic insertion of cochlear implant (CI) electrode arrays. In this study we evaluated the use of the RobOtol® (Collin, Bagneux, France) otologic robot to insert CI electrodes into the inner ear with intraoperative ECochG analysis. This prospective, pilot study included two adult patients implanted with Advanced Bionics (Westinghouse PI, CA, USA) cochlear implant, with HiFocus™ Mid-Scala electrode array. The standard surgical approach was used. For both subjects, who had residual hearing in the implanted ear, intraoperative and postoperative ECochG was performed with the AIMTM system. The surgeries were uneventful. A credible ECochG response was obtained after complete electrode insertion in both cases. Preoperative BC thresholds compared to intraoperative estimated ECochG thresholds and 2-day postoperative BC thresholds had similar values at frequencies where all thresholds were measurable. The results of the ECochG performed one month after the surgery showed that in both patients the hearing residues were preserved for the selected frequencies. The RobOtol® surgical robot allows for the correct, safe and gentle insertion of the cochlear implant electrode inside the cochlea. The use of electrocochleography measurements during robotic cochlear implantation offers an additional opportunity to evaluate and modify the electrode array insertion on an ongoing basis, which may contribute to the preservation of residual hearing.

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Robotics, automation, active electrode arrays, and new devices for cochlear implantation: A contemporary review

Cited by 20 publications

References 118 publications

Toward a cochlear implant electrode array with shape memory effect for post‐insertion perimodiolar positioning

Toward a cochlear implant electrode array with shape memory effect for post‐insertion perimodiolar positioning

Robotics and cochlear implant surgery: goals and developments

Robot-Assisted Electrode Insertion in Cochlear Implantation Controlled by Intraoperative Electrocochleography—A Pilot Study

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