Towards inferring positioning of straight cochlear‐implant electrode arrays during insertion using real‐time impedance sensing

• Published in: The international journal of medical robotics + computer assisted surgery Vol. 20; no. 1; pp. e2609 - n/a
• Main Authors: Riojas, Katherine E., Bruns, Trevor L., Granna, Josephine, Smetak, Miriam R., Labadie, Robert F., Webster, Robert J.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-02-2024
• Subjects: Arrays; Cochlea; Cochlea - surgery; cochlear implant; Cochlear Implantation; Cochlear Implants; Electric Impedance; Electrodes; Electrodes, Implanted; Humans; Impedance; impedance sensing; Insertion; robotic surgery; sensors; impedance sensing; sensors; cochlear implant; robotic surgery
• ISSN: 1478-5951; 1478-596X
• DOI: 10.1002/rcs.2609

Background
Cochlear‐implant electrode arrays (EAs) are currently inserted with limited feedback, and impedance sensing has recently shown promise for EA localisation.
Methods
We investigate the use of impedance sensing to infer the progression of an EA during insertion.
Results
We show that the access resistance component of bipolar impedance sensing can detect when a straight EA reaches key anatomical locations in a plastic cochlea and when each electrode contact enters/exits the cochlea. We also demonstrate that dual‐sided electrode contacts can provide useful proximity information and show the real‐time relationship between impedance and wall proximity in a cadaveric cochlea for the first time.
Conclusion
The access resistance component of bipolar impedance sensing has high potential for estimating positioning information of EAs relative to anatomy during insertion. Main limitations of this work include using saline as a surrogate for human perilymph in ex vivo models and using only one type of EA.