An automated insertion tool for cochlear implants: another step towards atraumatic cochlear implant surgery.
OBJECTIVE
Atraumatic electrode insertion has been identified to be a crucial step for the preservation of residual hearing abilities, which allows hybrid electro-acoustic stimulation (EAS). The authors propose a tool for automation of the insertion process to achieve this.


METHODS
General benefits as well as concept and design of an automated insertion tool are presented. Thirty insertions of Nucleus 24 Contour Advance Practice Electrodes in an artificial scala tympani model as well as 20 insertions in a human cochlea specimen were performed using the tool, implementing the AOS technique. For both studies, the achieved insertion depth angle was evaluated by photographic or X-ray documentation.


RESULTS
The mean achieved insertion depth angle was 410 degrees for the lubricated model and 330 degrees for the human cochlea specimen.


CONCLUSIONS
The automated insertion tool has proven its capability to perform electrode insertions with final insertion depth angles within the target range of a standard cochlear implant surgery. Additionally, to the knowledge of the authors, it represents the only possibility to automatically insert cochlear implant electrodes via minimally invasive approaches.
Hussong
Andreas
A
Institute of Mechatronic Systems (former Institute of Robotics), Leibniz Universität Hannover, Appelstrasse 11a, 30167, Hannover, Germany. andreas.hussong@imes.uni-hannover.de
Rau
Thomas S
TS
Ortmaier
Tobias
T
Heimann
Bodo
B
Lenarz
Thomas
T
Majdani
Omid
O
D000161:Acoustic Stimulation; D019929:Cochlear Implantation / Q000295:instrumentation* / Q000379:methods; D003054:Cochlear Implants; D004567:Electrodes, Implanted; D004867:Equipment Design; D006801:Humans; D055617:Micro-Electrical-Mechanical Systems / Q000295:instrumentation; D019060:Minimally Invasive Surgical Procedures; D015233:Models, Statistical