植入技术与电极特性对人工耳蜗植入力学特征影响的模型研究

Effect of electrode array type and insertion technique on the insertion force:in vitro cochlear model study

目的:探讨植入技术及电极特性对人工耳蜗植入力学特征的影响,为进一步优化电极设计、推动精准植入技术提供参考。方法:2019年7—12月将诺尔康标准电极、纤细电极、纤细加长电极,分别应用传统技术、机器人辅助技术(中速、低速)在耳蜗模型上进行电极植入。采用ATI Nano17Ti传感器及配套数据采集软件记录、分析植入过程力学信息。采用Origin 2020b软件进行统计学处理。结果:电极植入过程中,电极植入力随着植入深度的增加而逐步增大。传统技术下,纤细电极的植入力峰值显著小于标准电极[(71.0±16.6)mN比(140.9±52.7)mN,Z=3.683,P<0.01],纤细加长电极的植入力峰值介于标准电极、纤细电极之间,但差异无统计学意义(P值均>0.05),三款电极的瞬时力变化差异无统计学意义(P值均>0.05)。机器人辅助技术下中速、低速植入时,三款电极的力峰值特点与传统技术时相似,但中速时标准电极的瞬时力变化[(83.9±9.7)mN/s]显著大于纤细加长电极[(69.2±4.0)mN/s],低速时标准电极的瞬时力变化显著大于纤细、纤细加长电极。在电极条件相同的情况下,机器人技术均能较传统技术降低电极植入的力峰值和力变化,机器人中速和低速植入同种电极时的力峰值、瞬时力变化差异无统计学意义(P值均>0.05)。结论:电极的纤细化及机器人辅助技术的应用有助于植入力的减小。电极长度增加会增加传统技术的植入力控难度,应用机器人辅助技术则可实现良好力控。

Objective To investigate the effect of insertion technique and electrode array type on the insertion force of electrode array,and to provide a basis for further optimizing electrode design and facilitating mini-invasive electrode insertion.Methods Three types of electrode array from Nurotron(Standard Electrode,Slim-medium Electrode,Slim-long Electrode)were studied.from July 2019 to December 2019.These electrode arrays were inserted into the phantom models of the cochlea,manually or robot-assisted(medium speed and low speed).The real-time force during electrode array insertion was recorded by ATI Nano 17 Ti sensors and was analyzed by accessory software.Origin 2020b software was used for statistical processing.Results The insertion force of all electrode arrays progressively increased with the insertion depth.With the manual technique,the peak force of slim-medium electrode insertion was significantly smaller than that of the standard electrode insertion((71.0±16.6)mN vs(140.9±52.7)mN,Z=3.683,P<0.01),and the peak force of the slim-long electrode insertion was between the peak force of standard electrode and slim-medium electrode(P>0.05).No difference was found in the force variation of insertion among the three electrodes(P>0.05).With medium-speed and low-speed robotic assistance,the peak force characteristics of three electrodes were similar to those with the manual technique,but the force variation of standard electrode insertion((83.9±9.7)mN/s)at medium speed was significantly larger than that of the slim-long electrode insertion((69.2±4.0)mN/s),and the force variation of the standard electrode insertion at low speed was significantly greater than the other two electrodes.For the same electrode,robot-assisted insertion presented significantly lower peak force and force variation than manual insertion for each type of electrode array.But there was no difference in the peak force and force variation between two-speed levels of robot assistance(P>0.05).Conclusions The insertion force of the electrode array will be lower when a slim electrode array or robot technique is applied.Long electrode array might make manual insertion difficult or less precise.Robot assistance has advantage on force control during electrode array insertion.