In-Vitro Study of Speed and Alignment Angle in Cochlear Implant Electrode Array Insertions.

The insertion of the electrode array is a critical step in cochlear implantation. Herein we comprehensively investigate the impact of the alignment angle and feed-forward speed on deep insertions in artificial scala tympani models with accurate macro-anatomy and controlled frictional properties. Motorized insertions (n=1033) were performed in six scala tympani models with varying speeds and alignment angles. We evaluated reaction forces and micrographs of the insertion process and developed a mathematical model to estimate the normal force distribution along the electrode arrays. Insertions parallel to the cochlear base significantly reduce insertion energies and lead to smoother array movement. Non-constant insertion speeds allow to reduce insertion forces for a fixed total insertion time compared to a constant feed rate. In cochlear implantation, smoothness and peak forces can be reduced with alignment angles parallel to the scala tympani centerline and with non-constant feed-forward speed profiles. Our results may help to provide clinical guidelines and improve surgical tools for manual and automated cochlear implantation.