Efficiency of Assistant Robots in Cochlear Implant Surgery: A Systematic Review

Document Type : Review Articles

Authors

1 BSc Student, Student Research Committee (Treata), Department of Audiology, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

2 Instructor, Department of Audiology, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

3 -BSc Student, Student Research Committee (Treata), Department of Audiology, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

10.22122/jrrs.v13i1.2789

Abstract

Introduction: Cochlear implant (CI) surgery is an invasive procedure in order to create hearing sense. This procedure may cause some risks such as cochlear damage. Therefore, it is needed to reduce these risks as much as possible. Future CIs will address three general goals: 1) reducing cochlear damage during surgical insertion, 2) more efficient operation that reduces the load of electrical stimulation required to produce appropriate loudness, and 3) deeper insertion into the scala tympany (ST) cavity in order to access cochlear neurons related to lower frequencies. In order to achieve these goals, we need high degree of precision to which the use of an assistant robot in surgery might be a good solution. The aim of this study was to assess the efficiency of the robotic systems in the cochlear implant surgery.Materials and Methods: Published research was identified by reviewing the scientific databases (Pubmed, ScienceDirect and Google Scholar) from 1980 to 2017 using relevant keywords. The researches were selected based on the input and output criteria.Results: This study focused on three robotic systems. One of the robotic systems acts as a magnetic guide. This system uses a magnetically tipped CI to insert into the cochlea and also rotating manipulator magnet as a magnetic guide that is located near the patient’s head. The other robotic system determines the changes of the insertion angle of the electrode array into the cochlea by controlled electrode arrays insertion. The last robotic system reduces the invasiveness of the surgery by removing the need for mastoidectomy, replacing this with a direct tunnel approach known as direct cochlear access.Conclusion: These systems reduce the energy needed for the insertion of the electrode array, enable a deeper insertion into the cochlea in order to have an improved performance in CI, and reduce intracochlear damage during surgery. Therefore, both speech understanding in noise and sound quality will improve.

Keywords

  1. Wilson BS, Finley CC, Lawson DT, Wolford RD, Eddington DK, Rabinowitz WM. Better speech recognition with cochlear implants. Nature 1991; 352(6332): 236-8.
  2. McDermott HJ. Music perception with cochlear implants: a review. Trends Amplif 2004; 8(2): 49-82.
  3. Ryugo DK, Kretzmer EA, Niparko JK. Restoration of auditory nerve synapses in cats by cochlear implants. Science 2005; 310(5753): 1490-2.
  4. Clark GM. The multiple-channel cochlear implant: The interface between sound and the central nervous system for hearing, speech, and language in deaf people-a personal perspective. Philos Trans R Soc Lond B Biol Sci 2006; 361(1469): 791-810.
  5. Majdani O, Rau TS, Baron S, Eilers H, Baier C, Heimann B, et al. A robot-guided minimally invasive approach for cochlear implant surgery: preliminary results of a temporal bone study. Int J Comput Assist Radiol Surg 2009; 4(5): 475-86.
  6. Todd CA, Naghdy F, Svehla MJ. Force application during cochlear implant insertion: an analysis for improvement of surgeon technique. IEEE Trans Biomed Eng 2007; 54(7): 1247-55.
  7. Gurbani SS, Wilkening P, Zhao M, Gonenc B, Cheon GW, Iordachita II, et al. Robot-assisted three-dimensional registration for cochlear implant surgery using a common-path swept-source optical coherence tomography probe. J Biomed Opt 2014; 19(5): 057004.
  8. Erixon E, Hogstorp H, Wadin K, Rask-Andersen H. Variational anatomy of the human cochlea: implications for cochlear implantation. Otol Neurotol 2009; 30(1): 14-22.
  9. Escude B, James C, Deguine O, Cochard N, Eter E, Fraysse B. The size of the cochlea and predictions of insertion depth angles for cochlear implant electrodes. Audiol Neurootol 2006; 11(Suppl 1): 27-33.
  10. Kennedy DW. Multichannel intracochlear electrodes: Mechanism of insertion trauma. The Laryngoscope 1987; 97(1): 42-9.
  11. Su WY, Marion MS, Hinojosa R, Matz GJ. Anatomical measurements of the cochlear aqueduct, round window membrane, round window niche, and facial recess. Laryngoscope 1982; 92(5): 483-6.
  12. Hussong A, Rau T, Eilers H, Baron S, Heimann B, Leinung M, et al. Conception and design of an automated insertion tool for cochlear implants. Conf Proc IEEE Eng Med Biol Soc 2008; 2008: 5593-6.
  13. Labadie RF, Chodhury P, Cetinkaya E, Balachandran R, Haynes DS, Fenlon MR, et al. Minimally invasive, image-guided, facial-recess approach to the middle ear: demonstration of the concept of percutaneous cochlear access in vitro. Otol Neurotol 2005; 26(4): 557-62.
  14. Balachandran R, Mitchell JE, Blachon G, Noble JH, Dawant BM, Fitzpatrick JM, et al. Percutaneous cochlear implant drilling via customized frames: an in vitro study. Otolaryngol Head Neck Surg 2010; 142(3): 421-6.
  15. Labadie RF, Mitchell J, Balachandran R, Fitzpatrick JM. Customized, rapid-production microstereotactic table for surgical targeting: description of concept and in vitro validation. Int J Comput Assist Radiol Surg 2009; 4(3): 273-80.
  16. Klenzner T, Ngan CC, Knapp FB, Knoop H, Kromeier J, Aschendorff A, et al. New strategies for high precision surgery of the temporal bone using a robotic approach for cochlear implantation. Eur Arch Otorhinolaryngol 2009; 266(7): 955-60.
  17. Baron S, Eilers H, Munske B, Toennies JL, Balachandran R, Labadie RF, et al. Percutaneous inner-ear access via an image-guided industrial robot system. Proc Inst Mech Eng H 2010; 224(5): 633-49.
  18. Badaan SR, Stoianovici D. Robotic systems: Past, present, and future. In: Hemal AK, Menon M, editors. Robotics in genitourinary surgery. London, UK: Springer London; 2011. p. 655-65.
  19. Williamson T, Du X, Bell B, Coulson C, Caversaccio M, Proops D, et al. Mechatronic feasibility of minimally invasive, atraumatic cochleostomy. Biomed Res Int 2014; 2014: 181624.
  20. Maghribi M, Krulevitch P, Davidson J, Hamilton J. Implantable devices using magnetic guidance (Publication Number: US20060052656 A1). 2006. [Patents].
  21. Clark JR, Leon L, Warren FM, Abbott JJ. Investigation of magnetic guidance of cochlear implants. Proceedings of the 2011 IEEE/RSJ International Conference on Intelligent Robots and Systems; 2011 Sep 25-30; San Francisco, CA, USA. p. 1321-6.
  22. Clark JR, Warren FM, Abbott JJ. A Scalable Model for Human Scala-Tympani Phantoms. Journal of Medical Devices 2011; 5(1): 014501-5.
  23. Roland JT, Jr. A model for cochlear implant electrode insertion and force evaluation: results with a new electrode design and insertion technique. Laryngoscope 2005; 115(8): 1325-39.
  24. Schurzig D, Webster RJ 3rd, Dietrich MS, Labadie RF. Force of cochlear implant electrode insertion performed by a robotic insertion tool: comparison of traditional versus Advance Off-Stylet techniques. Otol Neurotol 2010; 31(8): 1207-10.
  25. Zhang J, Roland J, Manolidis S, Simaan N. Optimal Path planning for robotic insertion of steerable electrode arrays in cochlear implant surgery. J Med Devices 2008; 3(1): 011001.
  26. Zhang J, Wei W, Ding J, Roland JT, Jr., Manolidis S, Simaan N. Inroads toward robot-assisted cochlear implant surgery using steerable electrode arrays. Otol Neurotol 2010; 31(8): 1199-206.
  27. Majdani O, Schurzig D, Hussong A, Rau T, Wittkopf J, Lenarz T, et al. Force measurement of insertion of cochlear implant electrode arrays in vitro: comparison of surgeon to automated insertion tool. Acta Otolaryngol 2010; 130(1): 31-6.
  28. Hussong A, Rau TS, Ortmaier T, Heimann B, Lenarz T, Majdani O. An automated insertion tool for cochlear implants: another step towards atraumatic cochlear implant surgery. Int J Comput Assist Radiol Surg 2010; 5(2): 163-71.
  29. Rau TS, Hussong A, Leinung M, Lenarz T, Majdani O. Automated insertion of preformed cochlear implant electrodes: evaluation of curling behaviour and insertion forces on an artificial cochlear model. Int J Comput Assist Radiol Surg 2010; 5(2): 173-81.
  30. Schurzig D, Labadie RF, Hussong A, Rau TS, Webster RJ. A force sensing Automated Insertion Tool for cochlear electrode implantation. Proceedings of the 2010 IEEE International Conference on Robotics and Automation; 2010 May 3-8; Anchorage, Alaska. p. 3674-9.
  31. Zhang J, Bhattacharyya S, Simaan N. Model and parameter identification of friction during robotic insertion of cochlear-implant electrode arrays. Proceedings of the 2009 IEEE International Conference on Robotics and Automation; 2009 May 12-17; Kobe, Japan. p. 3859-64.
  32. Simaan N, Zhang J, Roland JT, Manolidi S. Steerable continuum robot design for cochlear implant surgery. Proceedings of the IEEE International Conference on Robotics and Automation Workshop on Snakes, Worms and Catheters: Continuum and Serpentine Robots for Minimally Invasive Surgery; 2010 May 3; Anchorage, USA.
  33. Schipper J, Aschendorff A, Arapakis I, Klenzner T, Teszler CB, Ridder GJ, et al. Navigation as a quality management tool in cochlear implant surgery. J Laryngol Otol 2004; 118(10): 764-70.
  34. Weber S, Bell B, Gerber N, Williamson T, Brett P, Du X, et al. Minimally invasive, robot assisted cochlear implantation. Proceedings of the 3rd Joint Workshop on New Technologies for Computer/Robot Assisted Surgery (CRAS 2013); 2013 Sep 11-13; Verona, Italy.
  35. Kratchman LB, Blachon GS, Withrow TJ, Balachandran R, Labadie RF, Webster RJ 3rd. Design of a bone-attached parallel robot for percutaneous cochlear implantation. IEEE Trans Biomed Eng 2011; 58(10): 2904-10.
  36. Kratchman LB, Schurzig D, McRackan TR, Balachandran R, Noble JH, Webster RJ 3rd, et al. A manually operated, advance off-stylet insertion tool for minimally invasive cochlear implantation surgery. IEEE Trans Biomed Eng 2012; 59(10): 2792-800.
  37. Diodato MD, Jr., Damiano RJ, Jr. Robotic cardiac surgery: Overview. Surg Clin North Am 2003; 83(6): 1351-67, ix.
  38. Falk V, Diegler A, Walther T, Autschbach R, Mohr FW. Developments in robotic cardiac surgery. Curr Opin Cardiol 2000; 15(6): 378-87.
  39. Labadie RF, Balachandran R, Noble JH, Blachon GS, Mitchell JE, Reda FA, et al. Minimally invasive image-guided cochlear implantation surgery: first report of clinical implementation. Laryngoscope 2014; 124(8): 1915-22.
  40. Assadi MZ, Du X, Dalton J, Henshaw S, Coulson CJ, Reid AP, et al. Comparison on intracochlear disturbances between drilling a manual and robotic cochleostomy. Proc Inst Mech Eng H 2013; 227(9): 1002-8.
  41. Brett PN, Taylor RP, Proops D, Coulson C, Reid A, Griffiths MV. A surgical robot for cochleostomy. Proceedings of the 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society; 2007 Aug 23-26; Lyon, France. p. 1229-32.
  42. Hochmair I, Hochmair E, Nopp P, Waller M, Jolly C. Deep electrode insertion and sound coding in cochlear implants. Hear Res 2015; 322: 14-23.
  • Receive Date: 04 May 2017
  • Revise Date: 28 March 2024
  • Accept Date: 22 May 2022