scholarly journals Corrigendum: Cochlear Size Assessment Predicts Scala Tympani Volume and Electrode Insertion Force- Implications in Robotic Assisted Cochlear Implant Surgery

2021 ◽  
Vol 8 ◽  
Author(s):  
Anandhan Dhanasingh ◽  
Chloe Swords ◽  
Manohar Bance ◽  
Vincent Van Rompaey ◽  
Paul Van de Heyning
Keyword(s):  
Cochlear Implant ◽  
Scala Tympani ◽  
Insertion Force ◽  
Implant Surgery ◽  
Robotic Assisted ◽  
Cochlear Implant Surgery ◽  
Electrode Insertion

Optimal Path Planning for Robotic Insertion of Steerable Electrode Arrays in Cochlear Implant Surgery

2008 ◽  
Vol 3 (1) ◽  
Author(s):  
Jian Zhang ◽  
J. Thomas Roland ◽  
Spiros Manolidis ◽  
Nabil Simaan
Keyword(s):  
Path Planning ◽  
Cochlear Implant ◽  
Optimal Path ◽  
Electrode Array ◽  
Scala Tympani ◽  
Electrode Arrays ◽  
Insertion Force ◽  
Optimal Path Planning ◽  
Cochlear Implant Surgery ◽  
Electrode Insertion

This paper presents an optimal path planning method of steerable electrode arrays for robot-assisted cochlear implant surgery. In this paper, the authors present a novel design of steerable electrode arrays that can actively bend at the tip. An embedded strand in the electrode array provides an active steering degrees-of-freedom (DoF). This paper addresses the calibration of the steerable electrode array and the optimal path planning for inserting it into planar and three-dimensional scala tympani models. The goal of the path planning is to minimize the intracochlear forces that the electrode array applies on the walls of the scala tympani during insertion. This problem is solved by designing insertion path planning algorithms that provide best fit between the shape of the electrode array and the curved scala tympani during insertion. Optimality measures that account for shape discrepancies between the steerable electrode array and the scala tympani are used to solve for the optimal path planning of the robot. Different arrangements of DoF and insertion speed force feedback (ISFF) are simulated and experimentally validated in this paper. A quality of insertion metric describing the gap between the steerable electrode array and the scala tympani model is presented and its correspondence to the insertion force is shown. The results of using 1DoF, 2DoF, and 4DoF electrode array insertion setups are compared. The 1DoF insertion setup uses nonsteerable electrode arrays. The 2DoF insertion setup uses single axis insertion with steerable electrode arrays. The 4DoF insertion setup allows full control of the insertion depth and the approach angle of the electrode with respect to the cochlea while using steerable electrode arrays. It is shown that using steerable electrode arrays significantly reduces the maximal insertion force (59.6% or more) and effectively prevents buckling of the electrode array. The 4DoF insertion setup further reduces the maximal electrode insertion forces. The results of using ISFF for steerable electrodes show a slight decrease in the insertion forces in contrast to a slight increase for nonsteerable electrodes. These results show that further research is required in order to determine the optimal ISFF control law and its effectiveness in reducing electrode insertion forces.

scholarly journals Cochlear Size Assessment Predicts Scala Tympani Volume and Electrode Insertion Force- Implications in Robotic Assisted Cochlear Implant Surgery

2021 ◽  
Vol 8 ◽  
Author(s):  
Anandhan Dhanasingh ◽  
Chloe Swords ◽  
Manohar Bance ◽  
Vincent Van Rompaey ◽  
Paul Van de Heyning
Keyword(s):  
Cochlear Implant ◽  
B Value ◽  
Scala Tympani ◽  
Insertion Force ◽  
B Values ◽  
Robotic Assisted ◽  
A Value ◽  
Straight Portion ◽  
The Mean ◽  
Electrode Insertion

Objectives: The primary aim was to measure the volume of the scala tympani (ST) and the length of the straight portion of the cochlear basal turn from micro-computed tomography (μCT) images. The secondary aim was to estimate the electrode insertion force based on cochlear size and insertion speed. Both of these objectives have a direct clinical relevance in robotic assisted cochlear implant (CI) surgery.Methods: The ST was segmented in thirty μCT datasets to create a three-dimensional (3D) model and calculate the ST volume. The diameter (A-value), the width (B-value), and the straight portion of the cochlear basal turn (S-value) were measured from the oblique coronal plane. Electrode insertion force was measured in ST models of two different sizes, by inserting FLEX24 (24 mm) and FLEX28 (28 mm) electrode arrays at five different speeds (0.1, 0.5, 1, 2, and 4 mm/s).Results: The mean A-, B-, and S-values measured from the 30 μCT datasets were 9.0 ± 0.5, 6.7 ± 0.4, and 6.9 mm ± 0.5, respectively. The mean ST volume was 34.2 μl ± 7 (range 23–50 μl). The ST volume increased linearly with an increase in A- and B-values (Pearson's coefficient r = 0.55 and 0.56, respectively). The A-value exhibited linear positive correlation with the B-value and S-value (Pearson's coefficient r = 0.64 and r = 0.66, respectively). In the smaller of the two ST models, insertion forces were higher across the range of insertion speeds during both array insertions, when compared to the upscaled model. Before the maximum electrode insertion depths, a trend toward lower insertion force for lower insertion speed and vice-versa was observed.Conclusion: It is important to determine pre-operative cochlear size as this seems to have an effect upon electrode insertion forces. Higher insertion forces were seen in a smaller sized ST model across two electrode array lengths, as compared to an upscaled larger model. The ST volume, which cannot be visualized on clinical CT, correlates with clinical cochlear parameters. This enabled the creation of an equation capable of predicting ST volume utilizing A- and B-values, thus enabling pre-operative prediction of ST volume.

Cochlear Implant Surgery Through Round Window Approach Is Always Possible

2019 ◽  
Vol 128 (6_suppl) ◽  
pp. 38S-44S ◽  
Author(s):  
Seong-Cheon Bae ◽  
You-Ree Shin ◽  
Young-Myoung Chun
Keyword(s):  
Cochlear Implant ◽  
Standard Procedure ◽  
Round Window ◽  
Lateral Wall ◽  
Anatomical Variations ◽  
Implant Surgery ◽  
Cochlear Implant Surgery ◽  
Alternative Procedures ◽  
Electrode Insertion ◽  
Window Approach

Objectives: The benefit of round window (RW) approach for cochlear implant (CI) has been well studied. Because the RW represents a natural door to scala tympani, it facilitates precise electrode insertion. Atraumatic electrode insertion can also be performed without drilling the cochlear lateral wall. However, the RW approach has several limitations. The purpose of this study is to describe successful CI surgeries utilizing the RW approach except for severe cases of temporal bone anomaly. The authors’ successful surgical solution for cases involving difficult RW access is also described. Materials and Methods: We retrospectively analyzed 377 consecutive surgeries of cochlear implantation performed between June 2010 and December 2018 by a single experienced surgeon. Standard and alternative procedures were used according to anatomical variations. Standard procedures included modified techniques of mastoidectomy in the RW approach, opening of facial recess, exposure of RW membrane, and electrode insertion. Difficult cases involving severe rotated cochlea or hypoplastic mastoid were successfully treated with RW insertion using alternative procedures such as external auditory canal (EAC) wall mobilization and endomeatal approach. Results: We performed CI surgery through a reproducible RW technique in two cases involving endomeatal approach and three cases of EAC mobilization. Other cases were treated using the standard procedure. Conclusion: Cochlear implant surgery through RW is reliable, safe, and effective. The RW technique is reproducible via several surgical procedures in most CI cases. Identification and safe exposure of RW membrane is a prerequisite for successful electrode insertion in cochlear implant surgery.

Problems and Complications of Cochlear Implant Surgery

1987 ◽  
Vol 96 (1_suppl) ◽  
pp. 14-15 ◽  
Author(s):  
N. L. Cohen ◽  
R. Rosenberg ◽  
S. Goldstein
Keyword(s):  
Cochlear Implant ◽  
Middle Ear ◽  
Scala Tympani ◽  
Careful Planning ◽  
Implant Surgery ◽  
Facial Recess ◽  
Scalp Flap ◽  
Cochlear Implant Surgery ◽  
Potential Problems ◽  
Attention To Detail

As with any operation, problems and complications may arise with cochlear implant surgery. These may be associated with the scalp flap, mastoid, facial recess, middle ear, or scala tympani. We describe a number of these potential problems and suggest means of avoiding or dealing with them. With careful planning and meticulous attention to detail, complications associated with cochlear implant surgery can be minimized.

The Use of Clinically Measurable Cochlear Parameters in Cochlear Implant Surgery as Indicators for Size, Shape, and Orientation of the Scala Tympani

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Daniel Schurzig ◽  
Max E. Timm, ◽  
Omid Majdani, ◽  
Thomas Lenarz, ◽  
Thomas S. Rau
Keyword(s):  
Cochlear Implant ◽  
Scala Tympani ◽  
Implant Surgery ◽  
Cochlear Implant Surgery

scholarly journals Qualitative assessment of YouTube videos as a source of patient information for cochlear implant surgery

2021 ◽  
pp. 1-4
Author(s):  
C Thomas ◽  
J Westwood ◽  
G F Butt
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implants ◽  
Qualitative Assessment ◽  
Supplementary Information ◽  
Implant Surgery ◽  
Critical Elements ◽  
Positive Elements ◽  
Cochlear Implant Surgery ◽  
Youtube Videos

Abstract Background YouTube is increasingly used as a source of healthcare information. This study evaluated the quality of videos on YouTube about cochlear implants. Methods YouTube was searched using the phrase ‘cochlear implant’. The first 60 results were screened by two independent reviewers. A modified Discern tool was used to evaluate the quality of each video. Results Forty-seven videos were analysed. The mean overall Discern score was 2.0 out of 5.0. Videos scored higher for describing positive elements such as the benefits of a cochlear implant (mean score of 3.4) and scored lower for negative elements such as the risks of cochlear implant surgery (mean score of 1.3). Conclusion The quality of information regarding cochlear implant surgery on YouTube is highly variable. These results demonstrated a bias towards the positive attributes of cochlear implants, with little mention of the risks or uncertainty involved. Although videos may be useful as supplementary information, critical elements required to make an informed decision are lacking. This is of particular importance when patients are considering surgery.

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