■在耳蜗植入(CI)手术中插入无创伤电极阵列(EA)的重要性已得到广泛认可,一致认为,由于EA插入引起的力与插入创伤直接相关。不幸的是,通过触觉反馈对这些力的手动感知本质上是有限的,和用于体内力测量以监测插入的技术尚不可用。解决这个差距,我们开发了一种力敏插入工具,能够在standardCI手术过程中捕获实时插入力。
■本文描述了该工具及其在临床环境中的开创性应用,并报告了正在进行的临床研究的初步发现。到目前为止,已经评估了五名患者的数据和经验,包括四名患者的力量概况。
■最初的术中经验是有希望的,成功集成到常规工作流程中。可以证明体内插入力测量的可行性和术中使用该工具的实用性。记录的体内插入力显示了随着插入深度增加的预期升高。插入末端的力范围为17.2mN至43.6mN,而在44.8mN至102.4mN的范围内观察到最大峰值力。
■我们假设这种新颖的方法具有帮助外科医生监测插入力的潜力,因此,最大限度地减少插入创伤,并确保更好地保留残余听力。使用此工具进行未来的数据记录可以成为正在进行的插入创伤原因研究的基础,为新的和改进的预防策略铺平道路。
UNASSIGNED: The significance of atraumatic electrode array (EA) insertion in cochlear implant (CI) surgery is widely acknowledged, with consensus that forces due to EA insertion are directly correlated with insertion trauma. Unfortunately, the manual perception of these forces through haptic feedback is inherently limited, and techniques for in vivo force measurements to monitor the insertion are not yet available. Addressing this gap, we developed of a force-sensitive insertion tool capable of capturing real-time insertion forces during standard CI surgery.
UNASSIGNED: This paper describes the tool and its pioneering application in a clinical setting and reports initial findings from an ongoing clinical study. Data and experiences from five patients have been evaluated so far, including force profiles of four patients.
UNASSIGNED: The initial intraoperative experiences are promising, with successful integration into the conventional workflow. Feasibility of in vivo insertion force measurement and practicability of the tool\'s intraoperative use could be demonstrated. The recorded in vivo insertion forces show the expected rise with increasing insertion depth. Forces at the end of insertion range from 17.2 mN to 43.6 mN, while maximal peak forces were observed in the range from 44.8 mN to 102.4 mN.
UNASSIGNED: We hypothesize that this novel method holds the potential to assist surgeons in monitoring the insertion forces and, thus, minimizing insertion trauma and ensuring better preservation of residual hearing. Future data recording with this tool can form the basis of ongoing research into the causes of insertion trauma, paving the way for new and improved prevention strategies.