2. Guiding cochlear implants into the ear like an airplane
Robot aligned with entry trajectory on phantom head. [Image from ARTORG Center for Biomedical Engineering Research, University of Bern]
Surgeons usually have to create an access point behind the ear through the skull. Then an electrode that bridges the damaged part of the inner ear to restore hearing is put into the cochlea through the access point – all of which is done manually.
The researchers noticed that using surgical planning software and a robotic drill created a tunnel that was about 2.5 mm in diameter and allowed a straight line, direct access to the cochlea. The hole is considered minimally-invasive, according to the researchers, and leaves a safe distance between the facial nerve and the chorda tympani nerve into the cochlea for the implant.
Using three interlocking safety components, the drill can be safely navigated inside the human ear and avoids damage to nerves and microscopic structures.
“The robot relies on a number of sensors which are a high-accuracy, optical tracking system, a sensor for resistance that can ‘feel’ the texture of the bone while drilling, and a radar-like nerve stimulation probe that sends small electric pulses into the bone from which the robot can compute whether or not it is on the preplanned track,” said Stefan Weber, a member of the ARTORG Center for Biomedical Engineering Research.
The surgeon knows where the robot is at all times and can control the drill safely.
“Our results encourage us that we have addressed many of the challenges of using a robot for cochlear implantation surgery,” said Marco Caversaccio, a member of the Department of ORL, Head and Neck Surgery at Inselspital in Bern.
The researchers suggest that the robot operates in the same way that avionics allows a plane to fly where instruments are controlled by read outs from the cockpit. The robot can perform procedures that a surgeon can’t do without the help of a robot. They hope to further develop the robot for drug delivery into the inner ear.
