Towards robotic embedding of cochlear implants in the temporal bone

Hermann, Jan; Ledergerber, Jonas; Wigger, Martin; Schneider, Daniel; Müller, Fabian Matthias; Weber, Stefan; O'Toole Bom Braga, Gabriela (19 September 2019). Towards robotic embedding of cochlear implants in the temporal bone. In: Burgert, Oliver; Hirt, Bernhard (eds.) 18. Jahrestagung der Deutschen Gesellschaft für Computer- und Roboterassistierte Chirurgie e.V. (CURAC). Reutlingen. 19. - 21. September 2019.

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The fixation of cochlear implant devices and their electrode is vital for long-term functionality. Today in robotic cochlear implantation, there is no standardized procedure for implant embedding in the temporal bone and dealing with excess electrode length. In this work, a robotic embedding approach for cochlear implants is proposed, and investigated in two experiments. In the first, the robotic system and suitable milling parameters were validated. It was shown that the robotic system can mill electrode channels in cortical bovine femur bone with an accuracy of 0.2 mm ± 0.1 mm and sufficient smoothness for successful electrode embedding. The second experiment in an upper-body phantom validated the proposed approach and clinical workflow. It showed in four example cases with different channel designs and implant bed positions that it was possible to mill and embed the cochlear implant, and to preoperatively plan the excess electrode lead length with sufficient accuracy.

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