2021/12/07 | Research | Surgical technologies

Minimal trauma in robotic CI implantation

During robotic cochlear implantation, an image-guided robotic system provides direct cochlear access to facilitate electrode array insertion. Aiming for a minimally traumatic approach, the Image Guided Therapy lab has recently proposed an extension of the robotic planning strategy to preserve the anatomical and functional integrity of critical intra-cochlear structures during robotic inner ear access.

Inner ear access constraints that minimize the angle of cochlear approach and maximize the round window membrane coverage ratio & the distance to critical intra-cochlear structures. (https://doi.org/10.3389/fsurg.2021.761217)

The research team introduced additional inner ear access constraints to evaluate an optimal trajectory using high resolution three- dimensional models of the middle and inner ear anatomy provided by the OpenEar data set. Trajectories were calculated that satisfy the hard constraints (anatomical safety margins) and optimize newly introduced soft constraints (maximize the round window membrane coverage & distance to critical intra-cochlear structures). The approach was tested and analyzed in a simulated surgical procedure.

With the additional constraints introduced, the optimal target region was determined to be in the antero-inferior region of the round window membrane. All intra-cochlear structures considered were preserved during simulated inner ear access.