title: Inroads toward robot-assisted cochlear implant surgery using steerable electrode arrays.
abstract: OBJECTIVE
  Robotic insertions of actively steerable perimodiolar electrode arrays can substantially reduce insertion forces and prevent electrode buckling.
  
  
  BACKGROUND
  Perimodiolar electrodes have been proven to be effective in reducing insertion forces. However, the dedicated techniques of atraumatic electrode insertion require intensive surgeon training. Although some specialized medical robots have been developed to help surgeons in certain minimally invasive surgeries, none are applicable to electrode insertions.
  
  
  METHODS
  A robot prototype capable of automatically inserting novel steerable electrode array and adjusting its approach angle toward the scala tympani has been constructed and tested. Comparisons of insertion forces using robotically assisted steerable and straight electrodes on scala tympani models are presented. Simulations and experiments are conducted to compare the robotic insertion outcomes and insertion forces.
  
  
  RESULTS
  The use of robotically assisted steerable electrodes for insertions significantly reduces the insertion forces compared with straight electrodes. Based on the results from the experiments, a second-generation robot with insertion force-sensing capability and haptic control to be used in the operating room has been designed for cochlear implant surgery.
  
  
  CONCLUSIONS
  Preliminary experimental results using robot-assisted steerable electrode prototype show that it is effective in reducing insertion forces and preventing electrode buckling. A second-generation robot has been designed and constructed for cochlear implant surgery under operating room conditions.
authors.affiliation: Department of Mechanical Engineering, Columbia University, New York, New York, USA.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Wei
authors.forename: Jienan
authors.initials: J
authors.lastname: Ding
authors.forename: J Thomas
authors.initials: JT
authors.lastname: Roland
authors.forename: Spiros
authors.initials: S
authors.lastname: Manolidis
authors.forename: Nabil
authors.initials: N
authors.lastname: Simaan
mesh_terms: D003051:Cochlea / Q000601:surgery*; D019929:Cochlear Implantation / Q000295:instrumentation* / Q000379:methods; D003054:Cochlear Implants; D004567:Electrodes, Implanted; D004867:Equipment Design; D006319:Hearing Loss, Sensorineural / Q000601:surgery*; D006801:Humans; D012371:Robotics / Q000295:instrumentation*; D012533:Scala Tympani / Q000601:surgery