Toward automated cochlear implant insertion using tubular manipulators

Granna, Josephine; Rau, Thomas S; Nguyen, Thien-Dang; Lenarz, Thomas; Majdani, Omid; Burgner-Kahrs, Jessica
Proceedings of SPIE 9786, Medical Imaging, pp. 97861F-1–8, 2016
Toward automated cochlear implant insertion using tubular manipulators


GermanyABSTRACTDuring manual cochlear implant electrode insertion the surgeon is at risk to damage the intracochlear fine-structure, as the electrode array is inserted through a small opening in the cochlea blindly with little force-feedback. This paper addresses a novel concept for cochlear electrode insertion using tubular manipulators toreduce risks of causing trauma during insertion and to automate the insertion process.We propose a tubular manipulator incorporated into the electrode array composed of an inner wire within atube, both elastic and helically shaped. It is our vision to use this manipulator to actuate the initially straightelectrode array during insertion into the cochlea by actuation of the wire and tube, i.e. translation and slightaxial rotation. In this paper, we evaluate the geometry of the human cochlea in 22 patient datasets in orderto derive design requirements for the manipulator. We propose an optimization algorithm to automaticallydetermine the tube set parameters (curvature, torsion, diameter, length) for an ideal final position within thecochlea. To prove our concept, we demonstrate that insertion can be realized in a follow-the-leader fashion for19 out of 22 cochleas. This is possible with only 4 different tube/wire sets.