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Development and Characterization of an Electrocochleography-Guided Robotics-Assisted Cochlear Implant Array Insertion System
Journal article   Peer reviewed

Development and Characterization of an Electrocochleography-Guided Robotics-Assisted Cochlear Implant Array Insertion System

Allan M. Henslee, Christopher R. Kaufmann, Matt D. Andrick, Parker T. Reineke, Viral D. Tejani and Marlan R. Hansen
Otolaryngology-head and neck surgery, Vol.167(2), pp.334-340
10/05/2021
DOI: 10.1177/01945998211049210
PMCID: PMC9969559
PMID: 34609909

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Abstract

Objective Electrocochleography (ECochG) is increasingly being used during cochlear implant (CI) surgery to detect and mitigate insertion-related intracochlear trauma, where a drop in ECochG signal has been shown to correlate with a decline in hearing outcomes. In this study, an ECochG-guided robotics-assisted CI insertion system was developed and characterized that provides controlled and consistent electrode array insertions while monitoring and adapting to real-time ECochG signals. Study Design Experimental research. Setting A research laboratory and animal testing facility. Methods A proof-of-concept benchtop study evaluated the ability of the system to detect simulated ECochG signal changes and robotically adapt the insertion. Additionally, the ECochG-guided insertion system was evaluated in a pilot in vivo sheep study to characterize the signal-to-noise ratio and amplitude of ECochG recordings during robotics-assisted insertions. The system comprises an electrode array insertion drive unit, an extracochlear recording electrode module, and a control console that interfaces with both components and the surgeon. Results The system exhibited a microvolt signal resolution and a response time <100 milliseconds after signal change detection, indicating that the system can detect changes and respond faster than a human. Additionally, animal results demonstrated that the system was capable of recording ECochG signals with a high signal-to-noise ratio and sufficient amplitude. Conclusion An ECochG-guided robotics-assisted CI insertion system can detect real-time drops in ECochG signals during electrode array insertions and immediately alter the insertion motion. The system may provide a surgeon the means to monitor and reduce CI insertion-related trauma beyond manual insertion techniques for improved CI hearing outcomes.
Life Sciences & Biomedicine Otorhinolaryngology Science & Technology Surgery

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