Visual feedback of insertion forces in cochlear implantation surgery

Introduction Inserting the electrode array (EA) into the delicate inner ear is the most crucial step in CI surgery. For hearing preservation minimizing insertion forces is beneficial. Recently, we have developed a tool for intraoperative force measurement. Here, methods are presented to provide this information to the surgeon in real time.

Material and Methods  Four different concepts for visual feedback of the measured forces were implemented. These concepts include a continuously updated force plot, a gauge, a bar plot, and color changing circle emulating a single, multicolor LED. Visual feedback was implemented in C++ using the framework Qt 5.12 and broadcast to an ARRISCOPE to be displayed as an inset in the top right corner. The visualization methods were experimentally evaluated in different tasks by up to 8 participants.

Results Visualization of the measured forces worked properly in all experiments. Our results indicate that all types of visual feedback are suitable for the desired application and helps to restrict insertion forces. Peripheral representation of the present forces was sufficient for all variants regardless of individual preferences indicated in the survey. Higher information density seems to be more valuable with increasing difficulty of the tasks.

Discussion and Conclusion The placement of visual feedback directly within the field of view aimed to prevent surgeons from having to frequently change focus to an external monitor. The ARRISCOPE was chosen due to its fully digital imaging gain. However, this makes the force sensing tool hardware-dependent. Force feedback using a multi-color LED at the tool’s tip visible through the microscope or acoustic feedback might be alternatives when aiming for a stand-alone device.

Federal Ministry of Eduucation and Research (BMBF, 13GW0367B) and Cluster of Excellence EXC 2177/1 “Hearing4all” (DFG, project ID 390895286)

Publication History

Article published online:
12 May 2023