A surgical robot specifically designed for high-precision cochlear implantation was recently developed by a team of engineers and surgeons from the Inselspital, Bern University Hospital and the ARTORG Center for Biomedical Engineering Research.
Electronic cochlear implant surgery requires immense precision and delicacy as the surgeon gains access to the inner ear through the skull bone. The implant is then carefully inserted into the damaged part of the patient’s ear through this access point. The procedure is typically done manually by a surgeon who directly views the process through the opening in the skull.
In order to improve upon current methods, the team was able to reach the inner ear through a tunnel approximately 2.5 mm in diameter using surgical planning software and a robotic drill. The size of this opening eliminated the surgeon’s direct visual control, extending beyond the capabilities of a human hand.
Computer-controlled safety procedures were implemented during the robot’s drilling process. The reduced size of the tunnel allows for a safe distance between two major nerves – the facial nerve and the chorda tympani nerve. Without damage, the implant’s electrode wire can be inserted with safe navigation at a pre-determined angle.
According to Stefan Weber, professor at the ARTORG Center for Biomedical Engineering Research, “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 pre-planned track.”
Recently, this robot-assisted cochlear surgery was successfully performed on a patient who was completely deaf in both ears due to a rare autoimmune disease. The patient is currently undergoing speech and language training, and can partially communicate via telephone six months after the procedure.
In addition to streamlining robotic cochlear implantation technology, the team has follow-up developments on the horizon, such as inner ear drug delivery.