Stevens James P, Watanabe Hirobumi, Kysar Jeffrey W, Lalwani Anil K
Department of Otolaryngology-Head and Neck Surgery, Columbia University College of Physicians and Surgeons, New York, New York.
Department of Mechanical Engineering, Columbia University, New York, New York.
J Biomed Mater Res A. 2016 Jul;104(7):1633-7. doi: 10.1002/jbm.a.35692. Epub 2016 Mar 11.
The round window membrane (RWM) has become the preferred route, over cochleostomy, for the introduction of cochlear implant electrodes as it minimizes inner ear trauma. However, in the absence of a tool designed for creating precise perforation, current practices lead to tearing of the RWM and significant intracochlear pressure fluctuations. On the basis of RWM mechanical properties, we have designed a multi-serrated needle to create consistent holes without membrane tearing or damaging inner ear structures. Four and eight-serrated needles were designed and produced with wire electrical discharge machining (EDM). The needle's ability to create RWM perforations was tested in deidentified, commercially acquired temporal bones with the assistance of a micromanipulator. Subsequently, specimens were imaged under light and scanning electron microscopy (SEM). The needles created consistent, appropriately sized holes in the membrane with minimal tearing. While a four-serrated crown needle made rectangular/trapezoid perforations, the octagonal crown formed smooth oval holes within the membrane. Though designed for single use, the needle tolerated repeated use without significant damage. The serrated needles formed precise perforations in the RWM while minimizing damage during cochlear implantation. The octagonal needle design created the preferred oval perforation better than the quad needle. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 1633-1637, 2016.
圆窗膜(RWM)已成为比耳蜗造口术更受青睐的耳蜗植入电极导入途径,因为它能将内耳创伤降至最低。然而,由于缺乏专门用于制造精确穿孔的工具,目前的操作会导致圆窗膜撕裂和耳蜗内压力显著波动。基于圆窗膜的机械性能,我们设计了一种多锯齿针,以制造出一致的孔洞,而不会撕裂膜或损坏内耳结构。通过电火花线切割加工(EDM)设计并制造了四锯齿和八锯齿针。在显微操作器的辅助下,在已去除身份标识的商业购买的颞骨上测试了该针制造圆窗膜穿孔的能力。随后,在光学显微镜和扫描电子显微镜(SEM)下对标本进行成像。这些针在膜上制造出一致且尺寸合适的孔洞,撕裂最小。虽然四锯齿冠状针制造出矩形/梯形穿孔,但八角形冠状针在膜内形成了光滑的椭圆形孔洞。尽管设计为一次性使用,但该针耐受反复使用而无明显损坏。锯齿针在圆窗膜上形成精确穿孔,同时在耳蜗植入过程中使损伤最小化。八角形针设计比四边形针能更好地制造出理想的椭圆形穿孔。© 2016威利期刊公司。《生物医学材料研究杂志》A部分:第104A卷:1633 - 1637页,2016年。