Towards inferring positioning of straight cochlear-implant electrode arrays during insertion using real-time impedance sensing.

Background: Cochlear-implant electrode arrays (EAs) are currently inserted with limited feedback, and impedance sensing has recently shown promise for EA localisation.

Methods: We investigate the use of impedance sensing to infer the progression of an EA during insertion.

Results: We show that the access resistance component of bipolar impedance sensing can detect when a straight EA reaches key anatomical locations in a plastic cochlea and when each electrode contact enters/exits the cochlea.

Robotic pullback technique of a precurved cochlear-implant electrode array using real-time impedance sensing feedback.

Purpose: During traditional insertion of cochlear implant (CI) electrode arrays (EAs), surgeons rely on limited tactile feedback and visualization of the EA entering the cochlea to control the insertion. One insertion approach for precurved EAs involves slightly overinserting the EA and then retracting it slightly to achieve closer hugging of the modiolus. In this work, we investigate whether electrical impedance sensing could be a valuable real-time feedback tool to advise this pullback technique.

Real-Time Localization of Cochlear-Implant Electrode Arrays Using Bipolar Impedance Sensing.

Objective: Surgeons have no direct objective feedback on cochlear-implant electrode array (EA) positioning during insertion, yet optimal hearing outcomes are contingent on placing the EA as close as feasible to viable neural endings. This paper describes a system to non-invasively determine intracochlear positioning of an EA, without requiring any modifications to existing commercial EAs themselves.

Methods: Electrical impedance has been suggested as a way to measure EA proximity to the inner wall of the cochlea that houses auditory nerve endings-the modiolus.

Magnetic Steering of Robotically Inserted Lateral-wall Cochlear-implant Electrode Arrays Reduces Forces on the Basilar Membrane In Vitro.

Hypothesis: Undesirable forces applied to the basilar membrane during surgical insertion of lateral-wall cochlear-implant electrode arrays (EAs) can be reduced via robotic insertion with magnetic steering of the EA tip.

Background: Robotic insertion of magnetically steered lateral-wall EAs has been shown to reduce insertion forces in vitro and in cadavers. No previous study of robot-assisted insertion has considered force on the basilar membrane.

Magnetically Steered Robotic Insertion of Cochlear-Implant Electrode Arrays: System Integration and First-In-Cadaver Results.

Cochlear-implant electrode arrays (EAs) must be inserted accurately and precisely to avoid damaging the delicate anatomical structures of the inner ear. It has previously been shown on the benchtop that using magnetic fields to steer magnet-tipped EAs during insertion reduces insertion forces, which correlate with insertion errors and damage to internal cochlear structures. This paper presents several advancements toward the goal of deploying magnetic steering of cochlear-implant EAs in the operating room.

Guiding Elastic Rods With a Robot-Manipulated Magnet for Medical Applications.

Magnet-tipped, elastic rods can be steered by an external magnetic field to perform surgical tasks. Such rods could be useful for a range of new medical applications because they do not require either pull wires or other bulky mechanisms that are problematic in small anatomical regions. However, current magnetic rod steering systems are large and expensive.

An Autoclavable Steerable Cannula Manual Deployment Device: Design and Accuracy Analysis.

Accessing a specific, predefined location identified in medical images is a common interventional task for biopsies and drug or therapy delivery. While conventional surgical needles provide little steerability, concentric tube continuum devices enable steering through curved trajectories. These devices are usually developed as robotic systems.