Details
| Original language | English |
|---|---|
| Pages (from-to) | 1643-1650 |
| Number of pages | 8 |
| Journal | IEEE Transactions on Biomedical Engineering |
| Volume | 70 |
| Issue number | 5 |
| Publication status | Published - 24 Nov 2022 |
Abstract
Objective: Residual hearing preservation during cochlear implant (CI) surgery is closely linked to the magnitude of intracochlear forces acting during the insertion process. So far, these forces have only been measured <italic>in vitro</italic>. Therefore, the range of insertion forces and the magnitude of damage-inducing thresholds in the human cochlea <italic>in vivo</italic> remain unknown. We aimed to develop a method to intraoperatively measure insertion forces without negatively affecting the established surgical workflow. Initial experiments showed that this requires the compensation of orientation-dependent gravitational forces. <italic>Methods:</italic> We devised design requirements for a force-sensing manual insertion tool. Experienced CI surgeons evaluated the proposed design for surgical safety and handling quality. Measured forces from automated and manual insertions into an artificial cochlea model were evaluated against data from a static external force sensor representing the gold standard. <italic>Results:</italic> The finalized manual insertion tool uses an embedded force sensor and inertial measurement unit to measure insertion forces. The evaluation of the proposed design shows the feasibility of orientation-independent insertion force measurements. Recorded forces correspond well to externally recorded reference forces after reliable removal of gravitational disturbances. CI surgeons successfully used the tool to insert electrode arrays into human cadaver cochleae. <italic>Conclusion:</italic> The presented positive evaluation poses the first step towards intraoperative use of the proposed tool. Further <italic>in vitro</italic> experiments with human specimens will ensure reliable <italic>in vivo</italic> measurements. <italic>Significance:</italic> Intraoperative insertion force measurements enabled by this tool will provide insights on the relationship between forces and hearing outcomes in cochlear implant surgery.
Keywords
- Cochlear implant, Gravity-independent force measurement, Insertion forces, Intraoperative insertion force measurement, Manual insertion tool
ASJC Scopus subject areas
- Engineering(all)
- Biomedical Engineering
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In: IEEE Transactions on Biomedical Engineering, Vol. 70, No. 5, 24.11.2022, p. 1643-1650.
Research output: Contribution to journal › Article › Research › peer review
}
TY - JOUR
T1 - A Tool to Enable Intraoperative Insertion Force Measurements for Cochlear Implant Surgery
AU - Böttcher-Rebmann, Georg
AU - Schell, Viktor
AU - Budde, Leon
AU - Zuniga, M. Geraldine
AU - Baier, Claas
AU - Lenarz, Thomas
AU - Rau, Thomas Stephan
PY - 2022/11/24
Y1 - 2022/11/24
N2 - Objective: Residual hearing preservation during cochlear implant (CI) surgery is closely linked to the magnitude of intracochlear forces acting during the insertion process. So far, these forces have only been measured in vitro. Therefore, the range of insertion forces and the magnitude of damage-inducing thresholds in the human cochlea in vivo remain unknown. We aimed to develop a method to intraoperatively measure insertion forces without negatively affecting the established surgical workflow. Initial experiments showed that this requires the compensation of orientation-dependent gravitational forces. Methods: We devised design requirements for a force-sensing manual insertion tool. Experienced CI surgeons evaluated the proposed design for surgical safety and handling quality. Measured forces from automated and manual insertions into an artificial cochlea model were evaluated against data from a static external force sensor representing the gold standard. Results: The finalized manual insertion tool uses an embedded force sensor and inertial measurement unit to measure insertion forces. The evaluation of the proposed design shows the feasibility of orientation-independent insertion force measurements. Recorded forces correspond well to externally recorded reference forces after reliable removal of gravitational disturbances. CI surgeons successfully used the tool to insert electrode arrays into human cadaver cochleae. Conclusion: The presented positive evaluation poses the first step towards intraoperative use of the proposed tool. Further in vitro experiments with human specimens will ensure reliable in vivo measurements. Significance: Intraoperative insertion force measurements enabled by this tool will provide insights on the relationship between forces and hearing outcomes in cochlear implant surgery.
AB - Objective: Residual hearing preservation during cochlear implant (CI) surgery is closely linked to the magnitude of intracochlear forces acting during the insertion process. So far, these forces have only been measured in vitro. Therefore, the range of insertion forces and the magnitude of damage-inducing thresholds in the human cochlea in vivo remain unknown. We aimed to develop a method to intraoperatively measure insertion forces without negatively affecting the established surgical workflow. Initial experiments showed that this requires the compensation of orientation-dependent gravitational forces. Methods: We devised design requirements for a force-sensing manual insertion tool. Experienced CI surgeons evaluated the proposed design for surgical safety and handling quality. Measured forces from automated and manual insertions into an artificial cochlea model were evaluated against data from a static external force sensor representing the gold standard. Results: The finalized manual insertion tool uses an embedded force sensor and inertial measurement unit to measure insertion forces. The evaluation of the proposed design shows the feasibility of orientation-independent insertion force measurements. Recorded forces correspond well to externally recorded reference forces after reliable removal of gravitational disturbances. CI surgeons successfully used the tool to insert electrode arrays into human cadaver cochleae. Conclusion: The presented positive evaluation poses the first step towards intraoperative use of the proposed tool. Further in vitro experiments with human specimens will ensure reliable in vivo measurements. Significance: Intraoperative insertion force measurements enabled by this tool will provide insights on the relationship between forces and hearing outcomes in cochlear implant surgery.
KW - Cochlear implant
KW - Gravity-independent force measurement
KW - Insertion forces
KW - Intraoperative insertion force measurement
KW - Manual insertion tool
UR - http://www.scopus.com/inward/record.url?scp=85144010187&partnerID=8YFLogxK
U2 - 10.1109/tbme.2022.3224528
DO - 10.1109/tbme.2022.3224528
M3 - Article
VL - 70
SP - 1643
EP - 1650
JO - IEEE Transactions on Biomedical Engineering
JF - IEEE Transactions on Biomedical Engineering
SN - 0018-9294
IS - 5
ER -