Abstract
Atraumatic insertions of electrode arrays (EA) into the cochlea aim to preserve natural structures and residual hearing. However, there is a limit as to how smooth and slow a surgeon can insert an EA. As a potential solution, we recently presented a tool (cochlea hydro drive, CHD) that makes use of an infusion pump to prompt and control the desired, continuous and very slow (< 1 mm/s) forward movement for such insertions. The present work further describes the onset, delay and cessation of the hydraulic actuation in response to different start and stop mechanisms, to better understand the safety of its application for cochlear implant surgery. Methods: Our previously designed tool was used to perform insertions of an EA into an artificial scala tympani model. The prototype is designed to hold an EA, which is then actuated by a standard infusion pump programmed to operate at 0.4 mm/ and 0.1 mm/s. A tubing system between the CHD and the pump includes a three-way valve. Ten insertions were operated using the functions of the pump and ten using the valve. Results: From the programmed start to the actual movement, we observed a larger average delay using the pump’s start function (5 s at 0.4 mm/s; 17 s at 0.1 mm/s) vs. opening the valve (< 0.7 s for both velocities). Moreover, the average cessation of movement with the valve closure was almost immediate (0.7 s for both velocities; this corresponds to < 0.1 mm with the slower tested velocity), as opposed to 60- 80 s delay when using the pump’s stop function. Conclusion: The use of a 3-way valve facilitates motion cessation to the high accuracy level required for cochlear implant surgery. These promising findings support future clinical translation of our tool.
A Pilot Study of Robot-Assisted Cochlear Implant Surgery Using Steerable Electrode Arrays
