Tactile Sensory Digit Feedback for Cochlear Implant Electrode Insertion

Cochlear Implantation (CI) which became a routine procedure for the last decades is an electronic device that provides a sense of sound for patients who are severely and profoundly deaf. The optimal success of this implantation depends on the electrode technology and deep insertion techniques. However, this manual insertion procedure may cause mechanical trauma which can lead to severe destruction of the delicate intracochlear structure. Accordingly, future improvement of the cochlear electrode implant insertion needs reduction of the excessive force application during the cochlear implantation which causes tissue damage and trauma. This study is examined tool-tissue interaction of large prototype scale digit embedded with distributive tactile sensor based upon cochlear electrode and large prototype scale cochlea phantom for simulating the human cochlear which could lead to small scale digit requirements. The digit, distributive tactile sensors embedded with silicon-substrate was inserted into the cochlea phantom to measure any digit/phantom interaction and position of the digit in order to minimize tissue and trauma damage during the electrode cochlear insertion. The digit have provided tactile information from the digitphantom insertion interaction such as contact status, tip penetration, obstacles, relative shape and location, contact orientation and multiple contacts. The tests demonstrated that even devices of such a relative simple design with low cost have potential to improve cochlear implant surgery and other lumen mapping applications by providing tactile sensory feedback information and thus controlling the insertion through sensing and control of the tip of the implant during the insertion. In that approach, the surgeon could minimize the tissue damage and potential damage to the delicate structures within the cochlear caused by current manual electrode insertion of the cochlear implantation. This approach also can be applied to other minimally invasive surgery applications as well as diagnosis and path navigation procedures.

Authors:

• Yusuf Bulale
• Mark Prince
• Geoff Tansley
• Peter Brett

Keywords:

• Cochlear electrode insertion
• distributive tactile sensory feedback information
• flexible digit
• minimally invasive surgery
• tool/tissue interaction.

References:

[1] Kha H. N., B. K. Chen, G. M. Clark, R. Jones, “Stiffness Properties for
Nucleus Standard Straight and Contour Electrode Arrays”, Medical
Engineering & Physics 26 (8), pp. 677-685, Jan 2004.
[2] Kale S, Cervantes VM, Wu MR, Pisano DV, Sheth N, Olson ES, “A
novel perfusion-based method for cochlear implant electrode insertion”
Hearing research, 314 (1-2), pp. 33-41, May 2014.
[3] Lawrence T. Cohen, Saunders E., Clark G. M. “Psychophysics of a
Prototype Perimodiolar Cochlear Implant Electrode Array”, Hearing
research, 155 (1-2), pp. 63-81, 2001.
[4] Adunka Oliver, Jan Kiefer and Chapel Hill, “Impact of Electrode
Insertion Depth on Intracochlear Trauma”, Otolaryngology-Head and
Neck surgery 135, pp.374-382, 2006.
[5] J. Wang, M., Bhatti, P. T., Arcand, B. Y., Beach, K., Friedrich, C.. R.,
Wise, K. D., “A cochlear Electrode Array with Built-in Position
Sensing”, International conference on Micro Electro Mechanical
systems (MEMS), IEEE Xplore, 18th. 30 Jan.-3 Feb. 2005.
[6] Frank Tendik, S. Shankar Sastry, Ronald S. Fearing, and Michael Cohn,
“Applications of Mechatronics in Minimally Invasive Surgery”,
IEEE/ASME transactions on mechatronics, 3(1), p.34-42, 2006.
[7] Peter S. Roland, Wolfgang Gstottner, Oliver Adunka, “Method for
hearing Preservation in cochlear implant surgery”, Operative
Technology in Otolaryngology 16, pp.93-100, 2005.
[8] N. Donnelly, A. Bibas, D. Jiang, D. E. Bamiou, C. Santulli, G.
Jeronimidis and A. Fitzgerald, “Effect of cochlear implant electrode
insertion on middle-ear function as measured by intra-operative laser
Doppler vibrometry”, The journal of laryngolgy and otology, 123,
pp.723-729, 2009.
[9] Joseph B. Roberson, Jr, M. D., “Cochlear implant surgery: Minimally
invasive technique”, Operative Techniques in Otolaryngology, 16,
pp.74-77, 2005.
[10] J. H. M. Frinjns, J. J. Briaire, A. Zarowski, B. M. Verbist and J.
Kuzma,“Concept and initial testing of a new, bassaly perimodiolar
electrode design”, international congress series 1273 p.105-108, 2004.
[11] Paolo Dario, Maria Chiarra Carrozza, Maurilio Marcacci(2000). A novel
mechatronic tool for computer-assisted arthroscopy. IEEE transaction on
information technology in biomedicine. 4(1), pp. 15-29.
[12] S. Shimachi, Y. Fujiwara and Y. Hakozaki (2004). New sensing method
of force acting on instrument for laparoscopic robot surgery, Computer
Assisted Radiology and Surgery. Proceedings of the 18th International
Congress and Exhibition International Congress Series, 1268, p.775-780.
[13] Stephen J. Rebscher Hetherington A, Bonham B, Wardrop P, Whinney
D, Leake P. A., “Consideration for design of future cochlear implant
electrode arrays: electrode array stiffness, size, and depth of insertion”,
Journal of Rehabilitation Research & Development (JRRD),45( 4)
pp.731-748, 2008.
[14] John K. Niparko, Cochlear implants: principles and practices, 2nd ed.
Philadelphia, Lippincott Williams and Wilkins, 2009.
[15] Uwe Baumann, Andrea Nobbe, “The cochlear implant electrode-pitch
function”, Hearing Research 213 (2006), pp34-42, 2006.
[16] Madhukar Vable, Mechanics of Materials, Oxford University press, 2nd
edition, August 2012.
[17] Bernard Escude, Chris James, Olivier Deguine, Nadine Cochard, Elias
Eter and Bernard Fraysse, The Size of the Cochlea and Predictions of
Insertion Depth Angles for Cochlear Implant Electrodes, Audiol
Neurotol 2006;11(suppl 1), pp.27–33, 2006.
[18] Lawrence T. Cohen, Saunders E., Clark G. M., “Psychophysics of a
prototype perimodiolar cochlear implant electrode array”, Hearing
research, 155 (1-2), pp. 63-81, 2001.
[19] Andress Hussong, Thomas S. Rau, Tobias Ortmaier, Bodo Heinmann,
Thomas Lenarz, Omid Majdani, “An automated insertion tool for
cochlear implants: another step towards atraumatic cochlear implant
surgery”, International Journal CARS, 5, pp.163-171, 2010.
[20] Graeme M. Clark, Review, “The multi-channel cochlear implant: Multidisciplinary
development of electrical stimulation of the cochlea and the
resulting clinical benefit”, Hearing research, 322, pp.4-13, 2015.
[21] Oliver Adunka, Marc H. Unkelbach, Martin G. Mack, Andreas Radeloff,
Wolfgang Gstoettner, “Predicting Basal Cochlear Length for Electric-
Acoustic Stimulation”, Arch Otolaryngol Head Neck Surg. 2005;131,
pp.488-492, 2005.
[22] Michael J. Wittbrodt, Charles R. Steele, Sunil Puria, “Developing a
Physical Model of the Human Cochlea Using Microfabrication
Methods”, Audio Neurotol 2006;11:104–112, Jan 2006.