A Tool to Enable Intraoperative Insertion Force Measurements for Cochlear Implant Surgery

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Bottcher-Rebmann, G.; Schell, V.; Budde, L.; Zuniga, M. Geraldine; Baier, C. et al.: A Tool to Enable Intraoperative Insertion Force Measurements for Cochlear Implant Surgery. In: IEEE Transactions on Biomedical Engineering (T-BME) 70 (2023), Nr. 5, S. 1643-1650. DOI: https://doi.org/10.1109/tbme.2022.3224528

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To cite the version in the repository, please use this identifier: https://doi.org/10.15488/13938

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Sum total of downloads: 23




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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.
License of this version: CC BY 4.0 Unported
Document Type: Article
Publishing status: publishedVersion
Issue Date: 2022
Appears in Collections:Forschungszentren

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1 image of flag of Germany Germany 9 39.13%
2 image of flag of United States United States 8 34.78%
3 image of flag of Czech Republic Czech Republic 3 13.04%
4 image of flag of France France 1 4.35%
5 image of flag of Canada Canada 1 4.35%
6 image of flag of Austria Austria 1 4.35%

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