Robotic Insertion Aid for Self-Coiling Cochlear Implants

MRS Advances ◽  
2016 ◽  
Vol 1 (1) ◽  
pp. 51-56
Author(s):  
Hans Ajieren ◽  
Radu Reit ◽  
Roxanne Lee ◽  
Tiffany Pham ◽  
Dongmei Shao ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Shape Memory ◽  
Cochlear Implants ◽  
Histological Analysis ◽  
Electrode Array ◽  
Shape Memory Polymers ◽  
The Self ◽  
Cochlear Duct ◽  
Future Studies ◽  
Insertion Tool

ABSTRACTThis study investigates the use of shape memory polymers (SMPs) as a substrate for a self-coiling cochlear implant electrode array and investigates the self-coiling ability of a sham probe micromachined atop such a substrate. Through the use of a self-coiling cochlear implant, the capability to avoid contact with the tissue of the cochlear duct is investigated via the insertion of a dummy device into a model cochlea heated to an ambient 34 °C. Finally, a prototype straightening and insertion tool is developed for automated retraction and locking of the coiled shape into a bar geometry. Preliminary demonstration of the deployment of self-coiling cochlear implants is shown and paves the way for future studies focused on using histological analysis of the cochlear wall tissue to compare the degree of trauma resulting from linear cochlear implant arrays versus the self-coiling, non-contact probes demonstrated herein.

Radiology for cochlear implants

1991 ◽  
Vol 105 (2) ◽  
pp. 85-88 ◽  
Author(s):  
R. F. Gray ◽  
R. A. Evans ◽  
C. E. L. Freer ◽  
H. E. Szutowicz ◽  
G. F. Maskell
Keyword(s):  
Cochlear Implants ◽  
Electrode Array ◽  
Base Line ◽  
Maximum Information ◽  
Cochlear Duct ◽  
Plain Films ◽  
Hearing Result ◽  
Frequency Map ◽  
Inexperienced Surgeon ◽  
Multichannel Electrode

AbstractOne fifth of patients selected for cochlear implants have such bony irregularities in the cochlear duct that full insertion of a multichannel electrode array is impossible. Three cases of cochlear deafness are presented where pre- and post-operative radiology played an important part in the management.Standard CT at 2 mm cuts is compared with ultra high resolution CT at 1 mm cuts. The pitfall of poor definition is that the inexperienced surgeon may find himself unexpectedly drilling out an obliterated cochlear duct. Sections 30 degrees caudal to Reid's infra orbito-meatal base line at 1 mm intervals give maximum information for minimum radiation.Plain films show the placement of individual platinum electrode contacts in relation to the spiral ‘frequency map’ of the cochlea. This is vital information for the audiologist who has to route specific frequencies to specific sites within the ear for a good hearing result.

An automated insertion tool for cochlear implants: another step towards atraumatic cochlear implant surgery

2009 ◽  
Vol 5 (2) ◽  
pp. 163-171 ◽  
Author(s):  
Andreas Hussong ◽  
Thomas S. Rau ◽  
Tobias Ortmaier ◽  
Bodo Heimann ◽  
Thomas Lenarz ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implants ◽  
Implant Surgery ◽  
Cochlear Implant Surgery ◽  
Insertion Tool

Genetic Causes of Hearing Loss in a Large Cohort of Cochlear Implant Recipients

2021 ◽  
pp. 019459982110213
Author(s):  
Kristen L. Seligman ◽  
A. Eliot Shearer ◽  
Kathy Frees ◽  
Carla Nishimura ◽  
Diana Kolbe ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Genetic Testing ◽  
Cochlear Implant ◽  
Cochlear Implants ◽  
Cochlear Implantation ◽  
Large Cohort ◽  
Future Studies ◽  
Genetic Causes ◽  
Adults And Children ◽  
The Relationship

Understanding genetic causes of hearing loss can determine the pattern and course of a patient’s hearing loss and may also predict outcomes after cochlear implantation. Our goal in this study was to evaluate genetic causes of hearing loss in a large cohort of adults and children with cochlear implants. We performed comprehensive genetic testing on all patients undergoing cochlear implantation. Of the 459 patients included in the study, 128 (28%) had positive genetic testing. In total, 44 genes were identified as causative. The top 5 genes implicated were GJB2 (20, 16%), TMPRSS3 (13, 10%), SLC26A4 (10, 8%), MYO7A (9, 7%), and MT-RNR1 (7, 5%). Pediatric patients had a higher diagnostic rate. This study lays the groundwork for future studies evaluating the relationship between genetic variation and cochlear implant performance.

A Simple Manual Roller Wheel Insertion Tool for Electrode Array Insertion in Minimally Invasive Cochlear Implant Surgery

2019 ◽  
Author(s):  
Narendran Narasimhan ◽  
Katherine E. Riojas ◽  
Trevor L. Bruns ◽  
Jason E. Mitchell ◽  
Robert J. Webster ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Cochlear Implant ◽  
Electrode Array ◽  
Invasive Procedure ◽  
Narrow Channel ◽  
Wide Field ◽  
Implant Surgery ◽  
Stereotactic Frame ◽  
Cochlear Implant Surgery ◽  
Insertion Tool

Image-guided, minimally-invasive cochlear implant surgery is a novel “keyhole” surgical approach for placing a cochlear implant electrode array eliminating the need for a wide-field mastoidectomy approach. Image guidance is used for path planning which is followed by the construction of a customized micro-stereotactic frame to drill a narrow channel from the skull surface to the cochlea. Herein, we present an insertion tool that uses roller wheels to advance the electrode array through the narrow tunnel and into the cochlea. Testing in a phantom revealed that when compared to insertions with surgical forceps, the new insertion tool was on average 26s faster, produced complete insertions more often (i.e. in 6/6 trials, vs. 1/6), and reduced array buckling (0/6 trials vs. 5/6). The tool provides a viable solution to complete the last step of this novel, minimally-invasive procedure. It also provides the advantage over previously developed manual insertion tools of enabling the surgeon to blindly actuate the roller wheel tool to advance the electrode into the tunnel. This allows the surgeon to visualize and guide insertion into the cochlea from a more advantageous visual perspective.

Incidence of Complete Insertion in Cochlear Implant Recipients of Long Lateral Wall Arrays

2021 ◽  
pp. 019459982098745
Author(s):  
Michael W. Canfarotta ◽  
Margaret T. Dillon ◽  
Kevin D. Brown ◽  
Harold C. Pillsbury ◽  
Matthew M. Dedmon ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Electrode Array ◽  
Lateral Wall ◽  
Electrode Arrays ◽  
Tertiary Referral ◽  
Insertion Depth ◽  
Future Studies ◽  
Tertiary Referral Center ◽  
Cochlear Duct Length ◽  
Cochlear Morphology

Objective High rates of partial insertion have been reported for cochlear implant (CI) recipients of long lateral wall electrode arrays, presumably caused by resistance encountered during insertion due to cochlear morphology. With recent advances in long-electrode array design, we sought to investigate (1) the incidence of complete insertions among patients implanted with 31.5-mm flexible arrays and (2) whether complete insertion is limited by cochlear duct length (CDL). Study Design Retrospective review. Setting Tertiary referral center. Methods Fifty-one adult CI recipients implanted with 31.5-mm flexible lateral wall arrays underwent postoperative computed tomography to determine the rate of complete insertion, defined as all contacts being intracochlear. CDL and angular insertion depth (AID) were compared between complete and partial insertion cohorts. Results Most cases had a complete insertion (96.1%, n = 49). Among the complete insertion cohort, the median CDL was 33.6 mm (range, 30.3-37.9 mm), and median AID was 641° (range, 533-751°). Two cases of partial insertion had relatively short CDL (31.8 mm and 32.3 mm) and shallow AID (542° and 575°). Relatively shallow AID for the 2 cases of partial insertion fails to support the idea that CDL alone prevents a complete insertion. Conclusion Complete insertion of a 31.5-mm flexible array is feasible in most cases and does not appear to be limited by the range of CDL observed in this cohort. Future studies are needed to estimate other variations in cochlear morphology that could predict resistance and failure to achieve complete insertion with long arrays.

scholarly journals A Manual Insertion Mechanism for Percutaneous Cochlear Implantation

2010 ◽  
Vol 4 (2) ◽  
Author(s):  
Daniel Schurzig ◽  
Zachariah W. Smith ◽  
D. Caleb Rucker ◽  
Robert F. Labadie ◽  
Robert J. Webster
Keyword(s):  
Minimally Invasive ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Image Guidance ◽  
Electrode Array ◽  
Narrow Channel ◽  
Invasive Technique ◽  
Custom Made ◽  
Insertion Mechanism ◽  
Insertion Tool

Percutaneous cochlear implantation (PCI) is a recently developed minimally invasive technique that utilizes image guidance and a custom-made microstereotactic frame to guide a drill directly to the cochlea. It enables cochlear access through a single drill port, reducing invasiveness in comparison to mastoidectomy. With the reduction in invasiveness, PCI enables a corresponding reduction in visualization and space in which to work at the cochlear entry point. This precludes standard cochlear implant deployment techniques and necessitates a new insertion tool that can deploy a cochlear implant into the cochlea while working down a deep, narrow channel. In this paper, we describe a manual insertion tool that we have developed for this purpose. The tool is capable of inserting an electrode array into the cochlea using the advance off-stylet technique, using simple manual controls on its handle.

scholarly journals Illustrating orientation changes of the insertion trajectory during cochlear implant electrode array insertion

2021 ◽  
Vol 7 (2) ◽  
pp. 113-116
Author(s):  
M. Geraldine Zuniga ◽  
Georg Böttcher ◽  
Viktor Schell ◽  
Thomas Lenarz ◽  
Thomas S. Rau
Keyword(s):  
Cochlear Implant ◽  
Range Of Motion ◽  
Negative Relationship ◽  
Electrode Array ◽  
Human Head ◽  
Initial Orientation ◽  
Contributing Factors ◽  
Cochlear Implant Surgery ◽  
Maximal Deviation ◽  
Insertion Tool

Abstract Introduction: Recent investigations focused on the optimization of atraumatic cochlear implant surgery have highlighted the relevance of the electrode array (EA) insertion trajectory. This is particularly studied in the context of minimally-invasive “keyhole” and robotic-assisted approaches, e.g. to avoid injuring structures inside and outside the cochlea. However, little is known about the natural, manual movements and trajectory followed during the insertion process. The present work illustrates the orientation changes within the trajectory a surgeon follows during insertions of EAs into a human cadaveric cochlea. Methods: An EA insertion tool equipped with a gyroscope was developed in our laboratory. During the insertion trials, the gyroscope captures the tool’s spatial orientation. A human head specimen and a single EA were used to perform insertions into a cochlea. A cochlear implant surgeon performed all insertion trials. The recorded orientations were compared to the initial orientation upon cochlea entry to assess the surgeon’s range of motion by calculating the angle between orientation vectors. Results: Fifteen EA insertions were performed with a median maximal deviation from the initial orientation of 7.2° (5.3 -11.1°) across trials. The largest orientation changes were seen towards the last half of each insertion trial. A negative relationship between degree of axis change and number of insertion trial was observed (r = -0.5). Conclusion: Manual EA insertions into a cadaveric cochlea revealed an insertion trajectory with maximum orientation changes of approximately < 10° degrees. The observed trend on decreasing range of motion with increasing number of insertion trials may be attributed to surgeon’s familiarization with the insertion trajectory for this specific specimen but other contributing factors (e.g. EA softening) need to be further elucidated with several EAs. Future evaluations can help determine if this orientation change is influenced by surgeon expertise.

Tissue Integration of Two Different Shape-Memory Polymers with Poly(ε-Caprolactone) Switching Segment in Rats

2008 ◽  
Author(s):  
Bernhard Hiebl ◽  
Dorothee Rickert ◽  
Rosemarie Fuhrmann ◽  
Friedrich Jung ◽  
Andres Lendlein ◽  
...  
Keyword(s):  
Shape Memory ◽  
Shape Memory Polymers ◽  
Tissue Integration
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