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A Simple Manual Roller Wheel Insertion Tool for Electrode Array Insertion in Minimally Invasive Cochlear Implant Surgery

[+] Author Affiliations
Narendran Narasimhan

Duke University, Durham, NC

Katherine E. Riojas, Trevor L. Bruns, Jason E. Mitchell, Robert J. Webster, III

Vanderbilt University Mechanical Engineering, Nashville, TN

Robert F. Labadie

Vanderbilt University Medical Center, Nashville, TN

Paper No. DMD2019-3249, pp. V001T06A003; 5 pages
doi:10.1115/DMD2019-3249
From:
  • 2019 Design of Medical Devices Conference
  • 2019 Design of Medical Devices Conference
  • Minneapolis, Minnesota, USA, April 15–18, 2019
  • ISBN: 978-0-7918-4103-7
  • Copyright © 2019 by ASME

abstract

Image-guided, minimally-invasive cochlear implant surgery is a novel “keyhole” surgical approach for placing a cochlear implant electrode array eliminating the need for a wide-field mastoidectomy approach. Image guidance is used for path planning which is followed by the construction of a customized micro-stereotactic frame to drill a narrow channel from the skull surface to the cochlea. Herein, we present an insertion tool that uses roller wheels to advance the electrode array through the narrow tunnel and into the cochlea. Testing in a phantom revealed that when compared to insertions with surgical forceps, the new insertion tool was on average 26s faster, produced complete insertions more often (i.e. in 6/6 trials, vs. 1/6), and reduced array buckling (0/6 trials vs. 5/6). The tool provides a viable solution to complete the last step of this novel, minimally-invasive procedure. It also provides the advantage over previously developed manual insertion tools of enabling the surgeon to blindly actuate the roller wheel tool to advance the electrode into the tunnel. This allows the surgeon to visualize and guide insertion into the cochlea from a more advantageous visual perspective.

Copyright © 2019 by ASME

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