Int J Comput Assist Radiol Surg. 2014 May;9(3):481-94. doi: 10.1007/s11548-013-0936-1.
Minimally invasive cochlear implantation and residual hearing preservation require both the surgical approach to the cochlea as well as the implant insertion to be performed in an atraumatic fashion. Considering the geometric limitations of this approach, specialized instrumentation is required to insert the electrode while preserving intracochlear membranes carrying the sensory hair cells.
An automated insertion tool for cochlear implants, which is capable of sensing insertion forces with a theoretical resolution of 30 μN, is presented. In contrast to previous designs, the custom force sensor is integrated in the insertion mechanism. Moreover, a test bench for insertion studies under constant and reproducible boundary conditions is proposed. It is used to experimentally validate the force sensing insertion tool, which is achieved by comparing the acquired forces to a ground truth measurement. The results of insertion studies on both an acrylic cochlear phantom and temporal bone specimen are given and discussed.
Results reveal that friction, occurring between the electrode carrier and the inside of the insertion tool guide tube, is likely to affect the force output of the proposed sensor. An appropriate method to compensate for these disturbances is presented and experimentally validated. Using the proposed approach to friction identification, a mean accuracy of (4.0±3.2) mN is observed.
The force information provided by the proposed, automated insertion tool can be used to detect complications during electrode insertion. However, in order to obtain accurate results, an identification of frictional forces prior to insertion is mandatory. The insertion tool is capable of automatically executing the appropriate trajectories.
微创耳蜗植入和残余听力保护需要手术方法和植入物插入都以非创伤性的方式进行。考虑到这种方法的几何限制，需要专门的仪器来插入电极，同时保护携带感觉毛细胞的耳蜗内膜。
介绍了一种用于耳蜗植入的自动插入工具，该工具能够以 30 μN 的理论分辨率感知插入力。与以前的设计相比，定制的力传感器集成在插入机构中。此外，还提出了一种用于在恒定和可重复边界条件下进行插入研究的测试台。它用于通过将获得的力与真实测量值进行比较来实验验证力感测插入工具。给出并讨论了在丙烯酸耳蜗模型和颞骨标本上进行插入研究的结果。
结果表明，电极载体和插入工具导管内部之间发生的摩擦可能会影响所提出传感器的力输出。提出了一种补偿这些干扰的适当方法，并进行了实验验证。使用所提出的摩擦识别方法，观察到平均精度为（4.0±3.2）mN。
所提出的自动插入工具提供的力信息可用于检测电极插入过程中的并发症。然而，为了获得准确的结果，在插入之前必须识别摩擦力。插入工具能够自动执行适当的轨迹。
