Home Tubular manipulators: a new concept for intracochlear positioning of an auditory prosthesis
Article Open Access

Tubular manipulators: a new concept for intracochlear positioning of an auditory prosthesis

  • Thomas S. Rau EMAIL logo , Josephine Granna , Thomas Lenarz , Omid Majdani and Jessica Burgner-Kahrs
Published/Copyright: September 12, 2015
Download Article (PDF)
Become an author with De Gruyter Brill
Author Information Explore this Subject
Current Directions in Biomedical Engineering
From the journal Current Directions in Biomedical Engineering Volume 1 Issue 1

Abstract

The aim of this study was to investigate the applicability of tubular manipulators as an actuator mechanism for intracochlear positioning of the electrode array (EA) of a cochlear implant (CI). This is motivated by the vision of an atraumatic insertion of the EA into the inner ear (cochlea) without any damage to the intracochlear structures in combination with a well-defined final position. To realize this, an actuator mechanism is required which allows consideration of the patient-specific anatomy. We propose a tubular manipulator for this task. It consists of three concentric tubes: A straight outer tube serves as a guiding sleeve to enter the inner ear (cochlea) and two additional telescoping, superelastic, helically precurved tubes. By selecting helical tube parameters of both tubes prior insertion, a patient-specific curling behaviour of the tubular manipulator can be achieved. For preliminary investigation, segmentation and skeletonization of 5 human scala tympani were performed to determine their centrelines. These centrelines were considered as individual ideal insertion paths. An optimization algorithm was developed to identify suitable tube set parameters (curvature, diameter, length, torsion, stiffness) as well as configuration parameters (translation and rotation of the 2 inner tubes). Different error values describing the deviation of the shape of the tubes with respect to the insertion path were used to quantify the optimization results. In all cases tube set parameters for a final position within the cochlea were found, while keeping the maximum error below 1mm. These preliminary results are promising in terms of the potential applicability of tubular manipulators for positioning auditory prosthesis inside the scala tympani of the inner ear.

Keywords: concentric tube manipulator; continuum robot; cochlear implant; electrode array; atraumatic insertion

1 Introduction

Cochlear implants have become the medical treatment of choice for patients suffering from deafness or severe hearing loss. To bypass the defect or highly ineffective organ of hearing, this neural prosthesis includes an electrode array (EA) which is inserted into the inner ear during a surgical procedure. This electrode array is used to apply electric fields which stimulate the hearing nerve, located in the central axis of the cochlea (referred to as the modiolus). Thereby, the cochlear implant allows for the perception of the sensation of sound [9]. The cochlea itself is a helical shaped hollow organ embedded in the temporal bone. It consists of three compartments separated by delicate membranous structures. The most important compartment for insertion of the CI electrode array is the scala tympani (ST), which is bounded by the basilar membrane (BM). The narrow dimensions of the ST (width: 1-2 mm [16]), its helical shape and the surrounding soft tissue structures make the electrode insertion an highly demanding surgical procedure.

Nowadays, research in the field of cochlear implants is dominated by the aim to improve preservation of these soft tissue structures for preservation of residual hearing [7]. Since v. Ilberg had described hearing preservation for the first time in 1999 [13] indication criteria have been extended to less severe hearing impairments [6]. Thus, atraumatic insertion of the electrode array into the scala tympani without harming the basilar membrane is required. One strategy is to develop very thin and flexible electrodes to reduce forces which occur while the— originally straight—implant is forwarded into the curved cochlea [14]. In contrast, there are some few research projects with the aim to manipulate the intracochlear movement of the electrode array to follow the spiral lumen of the scala tympani [2, 17]. This strategy necessitates that the patient-specific anatomy of the inner ear is taken into consideration as prerequisite for individualized CI electrode insertion. Initial results with steerable electrode arrays indicate a high potential for optimization of the insertion process: insertion forces could be reduced up to 70% compared to a not-optimized and not individualized insertion [17].

Figure 1 Schematic drawing of the tubular manipulator with straight guiding tube (1), helical outer (2) and inner tube (3) inside a model of a human scala tympani (4).
Figure 1

Schematic drawing of the tubular manipulator with straight guiding tube (1), helical outer (2) and inner tube (3) inside a model of a human scala tympani (4).

The main contribution of this paper is the proposal of a new concept for intracochlear positioning of the CI electrode array using tubular manipulators. We introduce design considerations and first results on the parameterization of the tubular manipulator. A preliminary study on 5 human datasets is presented to proof the concept.

2 Materials and methods

2.1 Concept

Our concept is motivated by the smallest among all continuum manipulators existent today: tubular manipulators (also referred to as concentric tube manipulators or active cannulas) [3, 15]. This needle sized manipulator is composed of multiple precurved, elastic, concentric tubes. By translating the tubes relative to one another and rotating them axially, the manipulator can achieve dexterous motion [1]. We propose to integrate a tubular manipulator into an EA such that the shape of the EA can be adjusted during insertion into the cochlea by manipulating the tubes until the optimal final pose of the EA is achieved.

2.2 Design considerations

As the ST exhibits a confined space and atraumatic insertion is desirable, it is indispensable that a follow-the-leader behaviour is achievable with the manipulator. Follow-the-leader behaviour means, that the manipulator’s backbone follows the path of its tip. This is only possible under specific boundary conditions on the tube’s parameters [4]. Actuation of the EA is realized by two tubes with helical precurvature and equal torsion. The requirements on the tube precurvature’s and torsion [4] are favourable for our application as the ST exhibits a helical shape. The proposed concept is illustrated in Figure 1. A straight guiding tube (1) is used to access the ST (4) through the round window, e.g. after surgical access to the inner ear is achieved by masteoidectomy. The helical outer (2) and inner (3) tube control the curling behavior of the EA during insertion. For this preliminary study, the total insertion depth was chosen as 18 mm in regard of the length of existing electrode arrays.

2.3 Proof of concept

To proof the feasibility of the proposed concept, tube parameters for 5 human cochleae are determined. The scala tympani are segmented in 5 anonymised patient data sets using the auto-segmentation algorithm developed by Noble et al. [10]. Skeletonization [8] and postprocessing are then performed in order to extract the centreline of each scala tympani. Finally, each centreline is transformed into a common frame using the consensus coordinate system described in [12].

We then optimize helical tube parameters numerically for each cochlea, i.e. tube curvatures, tube torsions, tube lengths, tube stiffness’, using sequential quadratic programming (SQP). The optimization process quantifies how well the resulting manipulator can conform to the centerline of the ST. Thus, the shape of the manipulator is determined using the kinematic model [4] and the mean and maximum deviation from the ST centreline as well as the tip error in the final pose is computed. Details on the optimization algorithms can be found in [5].

3 Results

We determined tube parameters for all 5 cochleae which allow for optimal conformance to the centreline of the ST. The tip error for all 5 cochleae was in the interval [0.16 mm; 0.63 mm], i.e. the Cartesian distance between the centreline tip and the tip of the tubular manipulator in its final position. The mean path accuracy error, i.e. the deviation from the tubular manipulator shape from the centreline along the length, was in the interval [0.29 mm; 0.46 mm], with the maximum error in [0.5 mm; 0.63 mm] (see Table 1). Tube parameters are summarized in Table 2. Figure 2 shows example results of tubular manipulators for a final position close and the centreline. Figure 3 shows an example simulation of the insertion of a tubular manipulator following the centreline of the ST.

Table 1

Error values for 5 cochleae.

CochleaMaximum Path Accuracy Error [mm]Mean Path Accuracy Error [mm]Tip Position Error [mm]
10.520.290.39
20.600.380.16
30.630.310.63
40.500.290.50
50.620.460.57
max0.630.460.63
Table 2

Individual tube parameters for all 5 cochleae which allow for optimal conformance to the centreline of the ST.

Cochleacurvature [1/m]torsion of both tubes [1/m]length tube 1 [mm]curvature tube 2 [1/m]length tube 2 [mm]inner diameter tube 1 [mm]outer diameter tube 1 [mm]inner diameter tube 2 [mm]outer diameter tube 2 [mm]
1552.1024.2015.8040.077.600.220.360.450.59
2450.1111.6516.1019.168.100.220.400.490.63
3537.9124.0516.5047.497.900.220.400.490.63
4533.1632.6616.2052.959.700.220.400.490.63
5482.7916.6216.8052.290.010.220.400.490.63
Figure 2 Final position of the tubular manipulator (left: Cochlea 2, right: Cochlea 3). Outer tube depicted in red, inner tube in blue. The centerline of ST is depicted as a red dotted line.
Figure 2

Final position of the tubular manipulator (left: Cochlea 2, right: Cochlea 3). Outer tube depicted in red, inner tube in blue. The centerline of ST is depicted as a red dotted line.

4 Discussion

Providing steerable electrode arrays is a challenging task in cochlear implant research. It requires both, accurate information about individual anatomy and a mechanism to manoeuvre the EA through the confined space of the ST following a predefined insertion path. Individual optimization of the insertion process has the potential to revolutionise the surgical treatment of patients with relevant residual hearing. A contact-less and therefore completely atraumatic insertion becomes feasible by the use of steerable electrode arrays—at least on a theoretical level as practical evidences in terms of temporal bone studies or clinical data are still missing.

To the best of our knowledge, this is the first investigation on the applicability of tubular manipulators as a mechanism for steerable CI electrode arrays. This initial feasibility study on 5 human cochleae datasets shows that this mechanism can in principle control the intracochlear movement of the electrode array. The deviations from the centreline of the cochleae are promising.

As a next step, this initial study needs to be extended to include more human cochleae datasets to cover a larger range of anatomical variations. Furthermore, it is essential to study the correlation between the deviation from the ideal insertion path and its impact regarding intracochlear trauma and clinical outcome. This requires building physical demonstrators and to perform insertion studies on artificial cochlear models [11] as well as temporal bone specimens.

An important aspect for getting this concept into clinical practice is the confirmation that the use of a limited number of tube sets is feasible [5]. This means that individualisation of the insertion process can be achieved by an individually optimized actuation of the tubular manipulator and not by patient-specific fabrication of CI electrode arrays. This will be investigated as soon as the larger data base is available.

Figure 3 Insertion process for cochlea 1. ST centerline is depicted as a blue dotted line. [Correction added after online publication 12 September 2015: Figure 3 was missing in the first online version]
Figure 3

Insertion process for cochlea 1. ST centerline is depicted as a blue dotted line. [Correction added after online publication 12 September 2015: Figure 3 was missing in the first online version]

5 Conclusion

These preliminary results support the idea of using tubular manipulators for positioning auditory prosthesis inside the scala tympani of the inner ear.

Funding: This work was supported by the German Research Foundation under award number BU-2935/1-1 and the Cluster of Excellence “Hearing4All”.

Author's Statement

  1. Conflict of interest: Authors state no conflict of interest. Material and Methods: Informed consent: Informed consent is not applicable. Ethical approval: The conducted research is not related to either human or animals use.

References

[1] Burgner-Kahrs J (2015) Task-specific Design of Tubular Continuum Robots for Surgical Applications. In: Verl A, Albu-Schäffer A, Brock O, Raatz A (Eds): Soft Robotics – Transferring Theory to Application, 222-230, Springer.10.1007/978-3-662-44506-8_19Search in Google Scholar

[2] Clark JR, Leon L, Warren FM, Abbott JJ (2012): Magnetic Guidance of Cochlear Implants: Proof-of-Concept and Initial Feasibility Study. Journal Medical Devices 6:0350021–8.10.1115/1.4007099Search in Google Scholar

[3] Dupont PE, Lock J, Itkowitz B, Butler E (2010): Design and Control of Concentric-Tube Robots. IEEE Trans Robot 26(2):209–225.10.1109/TRO.2009.2035740Search in Google Scholar PubMed PubMed Central

[4] Gilbert HB, Neimat J, Webster III RJ (2015): Concentric Tube Robots as Steerable Needles: Achieving Follow-the-Leader Deployment. IEEE Transactions on Robotics, pp. 1–13, 2015 (in print).10.1109/TRO.2015.2394331Search in Google Scholar PubMed PubMed Central

[5] Granna J, Rau TS, Nguyen TD, Majdani O, Burgner-Kahrs J (2015): Toward Automated Cochlear Implant Insertion using Tubular Manipulators. IEEE Int Conf Intell Rob Syst (in review)10.1117/12.2216854Search in Google Scholar

[6] Haumann S, Hohmann V, Meis M, Herzke T, Lenarz T, Büchner A (2012): Indication criteria for cochlear implants and hearing aids: impact of audiological and non-audiological findings. Audiology Research 2(1).10.4081/audiores.2012.e12Search in Google Scholar PubMed PubMed Central

[7] Irving S, Gillespie L, Richardson R, Rowe D, Fallon J, Wise A (2014): Electroacoustic Stimulation: Now and into the Future. Biomed Res. Int. Vol. 2014, pp. 1–17.10.1155/2014/350504Search in Google Scholar PubMed PubMed Central

[8] Lee T, Kashyap R, Chu C (1994): Building Skeleton Models via 3-D Medial Surface/Axis Thinning Algorithms,” Graphical Models and Image Processing 56(6):462–478.10.1006/cgip.1994.1042Search in Google Scholar

[9] Lenarz T, Pau H-W, Paasche G (2013): Cochlear Implants. Curr. Pharm. Biotechnol. 14(1):112–123.10.2174/1389201011314010014Search in Google Scholar

[10] Noble JH, Labadie RF, Majdani O, Dawant BM (2011): Automatic Segmentation of Intra-Cochlear Anatomy in Conventional CT. IEEE Trans Biomed Eng. 58(9):2625-32.10.1109/TBME.2011.2160262Search in Google Scholar PubMed PubMed Central

[11] Rau TS, Hussong A, Leinung M, Lenarz T, Majdani O (2010): Automated insertion of preformed cochlear implant electrodes: evaluation of curling behaviour and insertion forces on an artificial cochlear model. Int J Comput Assist Radiol Surg. 5(2):173-81.10.1007/s11548-009-0299-9Search in Google Scholar PubMed

[12] Verbist BM, Skinner MW, Cohen LT, Leake PA, James C, Box C, Holden TA, Finley CC, Roland PS, Roland JT Jr., Haller M, Patrick JF, Jolly CN, Faltys MA, Briaire JJ, Frijns JH (2010): Consensus panel on a cochlear coordinate system applicable in histologic, physiologic, and radiologic studies of the human cochlea. Otol Neurotol. 31(5):722–730.10.1097/MAO.0b013e3181d279e0Search in Google Scholar

[13] von Ilberg C, Kiefer J, Tillein J, Pfenningdorff T, Hartmann R, Stürzebecher E, Klinke R. (1999): Electric-acoustic stimulation of the auditory system. New technology for severe hearing loss. J ORL Relat Spec. 61(6):334-40.10.1159/000027695Search in Google Scholar

[14] von Ilberg CA, Baumann U, Kiefer J, Tillein J, Adunka OF (2011): Electric-acoustic stimulation of the auditory system: a review of the first decade. Audiol Neurootol. 16(S2):1-30.10.1159/isbn.978-3-8055-9784-5Search in Google Scholar

[15] Webster III RJ, Romano J, Cowan N (2009): Mechanics of Precurved-Tube Continuum Robots. IEEE Trans Robot 25(1):67-7810.1109/TRO.2008.2006868Search in Google Scholar

[16] Wysocki J (1999): Dimensions of the human vestibular and tympanic scalae. Hear Res 135:39-46.10.1016/S0378-5955(99)00088-XSearch in Google Scholar

[17] Zhang J, Xu K, Simaan N, Mandolidis S (2006): A Pilot Study of Robot-Assisted Cochlear Implant Surgery Using Steerable Electrode Arrays. Med Image Comput Comput Assist Interv 9(Pt 1):33–40.10.1007/11866565_5Search in Google Scholar PubMed

Published Online: 2015-9-12
Published in Print: 2015-9-1

© 2015 by Walter de Gruyter GmbH, Berlin/Boston

This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Articles in the same Issue

  1. Research Article
  2. Development and characterization of superparamagnetic coatings
  3. Research Article
  4. The development of an experimental setup to measure acousto-electric interaction signal
  5. Research Article
  6. Stability analysis of ferrofluids
  7. Research Article
  8. Investigation of endothelial growth using a sensors-integrated microfluidic system to simulate physiological barriers
  9. Research Article
  10. Energy harvesting for active implants: powering a ruminal pH-monitoring system
  11. Research Article
  12. New type of fluxgate magnetometer for the heart’s magnetic fields detection
  13. Research Article
  14. Field mapping of ballistic pressure pulse sources
  15. Research Article
  16. Development of a new homecare sleep monitor using body sounds and motion tracking
  17. Research Article
  18. Noise properties of textile, capacitive EEG electrodes
  19. Research Article
  20. Detecting phase singularities and rotor center trajectories based on the Hilbert transform of intraatrial electrograms in an atrial voxel model
  21. Research Article
  22. Spike sorting: the overlapping spikes challenge
  23. Research Article
  24. Separating the effect of respiration from the heart rate variability for cases of constant harmonic breathing
  25. Research Article
  26. Locating regions of arrhythmogenic substrate by analyzing the duration of triggered atrial activities
  27. Research Article
  28. Combining different ECG derived respiration tracking methods to create an optimal reconstruction of the breathing pattern
  29. Research Article
  30. Atrial and ventricular signal averaging electrocardiography in pacemaker and cardiac resynchronization therapy
  31. Research Article
  32. Estimation of a respiratory signal from a single-lead ECG using the 4th order central moments
  33. Research Article
  34. Compressed sensing of multi-lead ECG signals by compressive multiplexing
  35. Research Article
  36. Heart rate monitoring in ultra-high-field MRI using frequency information obtained from video signals of the human skin compared to electrocardiography and pulse oximetry
  37. Research Article
  38. Synchronization in wireless biomedical-sensor networks with Bluetooth Low Energy
  39. Research Article
  40. Automated classification of stages of anaesthesia by populations of evolutionary optimized fuzzy rules
  41. Research Article
  42. Effects of sampling rate on automated fatigue recognition in surface EMG signals
  43. Research Article
  44. Closed-loop transcranial alternating current stimulation of slow oscillations
  45. Research Article
  46. Cardiac index in atrio- and interventricular delay optimized cardiac resynchronization therapy and cardiac contractility modulation
  47. Research Article
  48. The role of expert evaluation for microsleep detection
  49. Research Article
  50. The impact of baseline wander removal techniques on the ST segment in simulated ischemic 12-lead ECGs
  51. Research Article
  52. Metal artifact reduction by projection replacements and non-local prior image integration
  53. Research Article
  54. A novel coaxial nozzle for in-process adjustment of electrospun scaffolds’ fiber diameter
  55. Research Article
  56. Processing of membranes for oxygenation using the Bellhouse-effect
  57. Research Article
  58. Inkjet printing of viable human dental follicle stem cells
  59. Research Article
  60. The use of an icebindingprotein out of the snowflea Hypogastrura harveyi as a cryoprotectant in the cryopreservation of mesenchymal stem cells
  61. Research Article
  62. New NIR spectroscopy based method to determine ischemia in vivo in liver – a first study on rats
  63. Research Article
  64. QRS and QT ventricular conduction times and permanent pacemaker therapy after transcatheter aortic valve implantation
  65. Research Article
  66. Adopting oculopressure tonometry as a transient in vivo rabbit glaucoma model
  67. Research Article
  68. Next-generation vision testing: the quick CSF
  69. Research Article
  70. Improving tactile sensation in laparoscopic surgery by overcoming size restrictions
  71. Research Article
  72. Design and control of a 3-DOF hydraulic driven surgical instrument
  73. Research Article
  74. Evaluation of endourological tools to improve the diagnosis and therapy of ureteral tumors – from model development to clinical application
  75. Research Article
  76. Frequency based assessment of surgical activities
  77. Research Article
  78. “Hands free for intervention”, a new approach for transoral endoscopic surgery
  79. Research Article
  80. Pseudo-haptic feedback in medical teleoperation
  81. Research Article
  82. Feasibility of interactive gesture control of a robotic microscope
  83. Research Article
  84. Towards structuring contextual information for workflow-driven surgical assistance functionalities
  85. Research Article
  86. Towards a framework for standardized semantic workflow modeling and management in the surgical domain
  87. Research Article
  88. Closed-loop approach for situation awareness of medical devices and operating room infrastructure
  89. Research Article
  90. Kinect based physiotherapy system for home use
  91. Research Article
  92. Evaluating the microsoft kinect skeleton joint tracking as a tool for home-based physiotherapy
  93. Research Article
  94. Integrating multimodal information for intraoperative assistance in neurosurgery
  95. Research Article
  96. Respiratory motion tracking using Microsoft’s Kinect v2 camera
  97. Research Article
  98. Using smart glasses for ultrasound diagnostics
  99. Research Article
  100. Measurement of needle susceptibility artifacts in magnetic resonance images
  101. Research Article
  102. Dimensionality reduction of medical image descriptors for multimodal image registration
  103. Research Article
  104. Experimental evaluation of different weighting schemes in magnetic particle imaging reconstruction
  105. Research Article
  106. Evaluation of CT capability for the detection of thin bone structures
  107. Research Article
  108. Towards contactless optical coherence elastography with acoustic tissue excitation
  109. Research Article
  110. Development and implementation of algorithms for automatic and robust measurement of the 2D:4D digit ratio using image data
  111. Research Article
  112. Automated high-throughput analysis of B cell spreading on immobilized antibodies with whole slide imaging
  113. Research Article
  114. Tissue segmentation from head MRI: a ground truth validation for feature-enhanced tracking
  115. Research Article
  116. Video tracking of swimming rodents on a reflective water surface
  117. Research Article
  118. MR imaging of model drug distribution in simulated vitreous
  119. Research Article
  120. Studying the extracellular contribution to the double wave vector diffusion-weighted signal
  121. Research Article
  122. Artifacts in field free line magnetic particle imaging in the presence of inhomogeneous and nonlinear magnetic fields
  123. Research Article
  124. Introducing a frequency-tunable magnetic particle spectrometer
  125. Research Article
  126. Imaging of aortic valve dynamics in 4D OCT
  127. Research Article
  128. Intravascular optical coherence tomography (OCT) as an additional tool for the assessment of stent structures
  129. Research Article
  130. Simple concept for a wide-field lensless digital holographic microscope using a laser diode
  131. Research Article
  132. Intraoperative identification of somato-sensory brain areas using optical imaging and standard RGB camera equipment – a feasibility study
  133. Research Article
  134. Respiratory surface motion measurement by Microsoft Kinect
  135. Research Article
  136. Improving image quality in EIT imaging by measurement of thorax excursion
  137. Research Article
  138. A clustering based dual model framework for EIT imaging: first experimental results
  139. Research Article
  140. Three-dimensional anisotropic regularization for limited angle tomography
  141. Research Article
  142. GPU-based real-time generation of large ultrasound volumes from freehand 3D sweeps
  143. Research Article
  144. Experimental computer tomograph
  145. Research Article
  146. US-tracked steered FUS in a respiratory ex vivo ovine liver phantom
  147. Research Article
  148. Contribution of brownian rotation and particle assembly polarisation to the particle response in magnetic particle spectrometry
  149. Research Article
  150. Preliminary investigations of magnetic modulated nanoparticles for microwave breast cancer detection
  151. Research Article
  152. Construction of a device for magnetic separation of superparamagnetic iron oxide nanoparticles
  153. Research Article
  154. An IHE-conform telecooperation platform supporting the treatment of dementia patients
  155. Research Article
  156. Automated respiratory therapy system based on the ARDSNet protocol with systemic perfusion control
  157. Research Article
  158. Identification of surgical instruments using UHF-RFID technology
  159. Research Article
  160. A generic concept for the development of model-guided clinical decision support systems
  161. Research Article
  162. Evaluation of local alterations in femoral bone mineral density measured via quantitative CT
  163. Research Article
  164. Creating 3D gelatin phantoms for experimental evaluation in biomedicine
  165. Research Article
  166. Influence of short-term fixation with mixed formalin or ethanol solution on the mechanical properties of human cortical bone
  167. Research Article
  168. Analysis of the release kinetics of surface-bound proteins via laser-induced fluorescence
  169. Research Article
  170. Tomographic particle image velocimetry of a water-jet for low volume harvesting of fat tissue for regenerative medicine
  171. Research Article
  172. Wireless medical sensors – context, robustness and safety
  173. Research Article
  174. Sequences for real-time magnetic particle imaging
  175. Research Article
  176. Speckle-based off-axis holographic detection for non-contact photoacoustic tomography
  177. Research Article
  178. A machine learning approach for planning valve-sparing aortic root reconstruction
  179. Research Article
  180. An in-ear pulse wave velocity measurement system using heart sounds as time reference
  181. Research Article
  182. Measuring different oxygenation levels in a blood perfusion model simulating the human head using NIRS
  183. Research Article
  184. Multisegmental fusion of the lumbar spine a curse or a blessing?
  185. Research Article
  186. Numerical analysis of the biomechanical complications accompanying the total hip replacement with NANOS-Prosthetic: bone remodelling and prosthesis migration
  187. Research Article
  188. A muscle model for hybrid muscle activation
  189. Research Article
  190. Mathematical, numerical and in-vitro investigation of cooling performance of an intra-carotid catheter for selective brain hypothermia
  191. Research Article
  192. An ideally parameterized unscented Kalman filter for the inverse problem of electrocardiography
  193. Research Article
  194. Interactive visualization of cardiac anatomy and atrial excitation for medical diagnosis and research
  195. Research Article
  196. Virtualizing clinical cases of atrial flutter in a fast marching simulation including conduction velocity and ablation scars
  197. Research Article
  198. Mesh structure-independent modeling of patient-specific atrial fiber orientation
  199. Research Article
  200. Accelerating mono-domain cardiac electrophysiology simulations using OpenCL
  201. Research Article
  202. Understanding the cellular mode of action of vernakalant using a computational model: answers and new questions
  203. Research Article
  204. A java based simulator with user interface to simulate ventilated patients
  205. Research Article
  206. Evaluation of an algorithm to choose between competing models of respiratory mechanics
  207. Research Article
  208. Numerical simulation of low-pulsation gerotor pumps for use in the pharmaceutical industry and in biomedicine
  209. Research Article
  210. Numerical and experimental flow analysis in centifluidic systems for rapid allergy screening tests
  211. Research Article
  212. Biomechanical parameter determination of scaffold-free cartilage constructs (SFCCs) with the hyperelastic material models Yeoh, Ogden and Demiray
  213. Research Article
  214. FPGA controlled artificial vascular system
  215. Research Article
  216. Simulation based investigation of source-detector configurations for non-invasive fetal pulse oximetry
  217. Research Article
  218. Test setup for characterizing the efficacy of embolic protection devices
  219. Research Article
  220. Impact of electrode geometry on force generation during functional electrical stimulation
  221. Research Article
  222. 3D-based visual physical activity assessment of children
  223. Research Article
  224. Realtime assessment of foot orientation by Accelerometers and Gyroscopes
  225. Research Article
  226. Image based reconstruction for cystoscopy
  227. Research Article
  228. Image guided surgery innovation with graduate students - a new lecture format
  229. Research Article
  230. Multichannel FES parameterization for controlling foot motion in paretic gait
  231. Research Article
  232. Smartphone supported upper limb prosthesis
  233. Research Article
  234. Use of quantitative tremor evaluation to enhance target selection during deep brain stimulation surgery for essential tremor
  235. Research Article
  236. Evaluation of adhesion promoters for Parylene C on gold metallization
  237. Research Article
  238. The influence of metallic ions from CoCr28Mo6 on the osteogenic differentiation and cytokine release of human osteoblasts
  239. Research Article
  240. Increasing the visibility of thin NITINOL vascular implants
  241. Research Article
  242. Possible reasons for early artificial bone failure in biomechanical tests of ankle arthrodesis systems
  243. Research Article
  244. Development of a bending test procedure for the characterization of flexible ECoG electrode arrays
  245. Research Article
  246. Tubular manipulators: a new concept for intracochlear positioning of an auditory prosthesis
  247. Research Article
  248. Investigation of the dynamic diameter deformation of vascular stents during fatigue testing with radial loading
  249. Research Article
  250. Electrospun vascular grafts with anti-kinking properties
  251. Research Article
  252. Integration of temperature sensors in polyimide-based thin-film electrode arrays
  253. Research Article
  254. Use cases and usability challenges for head-mounted displays in healthcare
  255. Research Article
  256. Device- and service profiles for integrated or systems based on open standards
  257. Research Article
  258. Risk management for medical devices in research projects
  259. Research Article
  260. Simulation of varying femoral attachment sites of medial patellofemoral ligament using a musculoskeletal multi-body model
  261. Research Article
  262. Does enhancing consciousness for strategic planning processes support the effectiveness of problem-based learning concepts in biomedical education?
  263. Research Article
  264. SPIO processing in macrophages for MPI: The breast cancer MPI-SNLB-concept
  265. Research Article
  266. Numerical simulations of airflow in the human pharynx of OSAHS patients
https://doi.org/10.1515/cdbme-2015-0123
Keywords for this article
concentric tube manipulator; continuum robot; cochlear implant; electrode array; atraumatic insertion
Creative Commons
BY-NC-ND 3.0

Articles in the same Issue

  1. Research Article
  2. Development and characterization of superparamagnetic coatings
  3. Research Article
  4. The development of an experimental setup to measure acousto-electric interaction signal
  5. Research Article
  6. Stability analysis of ferrofluids
  7. Research Article
  8. Investigation of endothelial growth using a sensors-integrated microfluidic system to simulate physiological barriers
  9. Research Article
  10. Energy harvesting for active implants: powering a ruminal pH-monitoring system
  11. Research Article
  12. New type of fluxgate magnetometer for the heart’s magnetic fields detection
  13. Research Article
  14. Field mapping of ballistic pressure pulse sources
  15. Research Article
  16. Development of a new homecare sleep monitor using body sounds and motion tracking
  17. Research Article
  18. Noise properties of textile, capacitive EEG electrodes
  19. Research Article
  20. Detecting phase singularities and rotor center trajectories based on the Hilbert transform of intraatrial electrograms in an atrial voxel model
  21. Research Article
  22. Spike sorting: the overlapping spikes challenge
  23. Research Article
  24. Separating the effect of respiration from the heart rate variability for cases of constant harmonic breathing
  25. Research Article
  26. Locating regions of arrhythmogenic substrate by analyzing the duration of triggered atrial activities
  27. Research Article
  28. Combining different ECG derived respiration tracking methods to create an optimal reconstruction of the breathing pattern
  29. Research Article
  30. Atrial and ventricular signal averaging electrocardiography in pacemaker and cardiac resynchronization therapy
  31. Research Article
  32. Estimation of a respiratory signal from a single-lead ECG using the 4th order central moments
  33. Research Article
  34. Compressed sensing of multi-lead ECG signals by compressive multiplexing
  35. Research Article
  36. Heart rate monitoring in ultra-high-field MRI using frequency information obtained from video signals of the human skin compared to electrocardiography and pulse oximetry
  37. Research Article
  38. Synchronization in wireless biomedical-sensor networks with Bluetooth Low Energy
  39. Research Article
  40. Automated classification of stages of anaesthesia by populations of evolutionary optimized fuzzy rules
  41. Research Article
  42. Effects of sampling rate on automated fatigue recognition in surface EMG signals
  43. Research Article
  44. Closed-loop transcranial alternating current stimulation of slow oscillations
  45. Research Article
  46. Cardiac index in atrio- and interventricular delay optimized cardiac resynchronization therapy and cardiac contractility modulation
  47. Research Article
  48. The role of expert evaluation for microsleep detection
  49. Research Article
  50. The impact of baseline wander removal techniques on the ST segment in simulated ischemic 12-lead ECGs
  51. Research Article
  52. Metal artifact reduction by projection replacements and non-local prior image integration
  53. Research Article
  54. A novel coaxial nozzle for in-process adjustment of electrospun scaffolds’ fiber diameter
  55. Research Article
  56. Processing of membranes for oxygenation using the Bellhouse-effect
  57. Research Article
  58. Inkjet printing of viable human dental follicle stem cells
  59. Research Article
  60. The use of an icebindingprotein out of the snowflea Hypogastrura harveyi as a cryoprotectant in the cryopreservation of mesenchymal stem cells
  61. Research Article
  62. New NIR spectroscopy based method to determine ischemia in vivo in liver – a first study on rats
  63. Research Article
  64. QRS and QT ventricular conduction times and permanent pacemaker therapy after transcatheter aortic valve implantation
  65. Research Article
  66. Adopting oculopressure tonometry as a transient in vivo rabbit glaucoma model
  67. Research Article
  68. Next-generation vision testing: the quick CSF
  69. Research Article
  70. Improving tactile sensation in laparoscopic surgery by overcoming size restrictions
  71. Research Article
  72. Design and control of a 3-DOF hydraulic driven surgical instrument
  73. Research Article
  74. Evaluation of endourological tools to improve the diagnosis and therapy of ureteral tumors – from model development to clinical application
  75. Research Article
  76. Frequency based assessment of surgical activities
  77. Research Article
  78. “Hands free for intervention”, a new approach for transoral endoscopic surgery
  79. Research Article
  80. Pseudo-haptic feedback in medical teleoperation
  81. Research Article
  82. Feasibility of interactive gesture control of a robotic microscope
  83. Research Article
  84. Towards structuring contextual information for workflow-driven surgical assistance functionalities
  85. Research Article
  86. Towards a framework for standardized semantic workflow modeling and management in the surgical domain
  87. Research Article
  88. Closed-loop approach for situation awareness of medical devices and operating room infrastructure
  89. Research Article
  90. Kinect based physiotherapy system for home use
  91. Research Article
  92. Evaluating the microsoft kinect skeleton joint tracking as a tool for home-based physiotherapy
  93. Research Article
  94. Integrating multimodal information for intraoperative assistance in neurosurgery
  95. Research Article
  96. Respiratory motion tracking using Microsoft’s Kinect v2 camera
  97. Research Article
  98. Using smart glasses for ultrasound diagnostics
  99. Research Article
  100. Measurement of needle susceptibility artifacts in magnetic resonance images
  101. Research Article
  102. Dimensionality reduction of medical image descriptors for multimodal image registration
  103. Research Article
  104. Experimental evaluation of different weighting schemes in magnetic particle imaging reconstruction
  105. Research Article
  106. Evaluation of CT capability for the detection of thin bone structures
  107. Research Article
  108. Towards contactless optical coherence elastography with acoustic tissue excitation
  109. Research Article
  110. Development and implementation of algorithms for automatic and robust measurement of the 2D:4D digit ratio using image data
  111. Research Article
  112. Automated high-throughput analysis of B cell spreading on immobilized antibodies with whole slide imaging
  113. Research Article
  114. Tissue segmentation from head MRI: a ground truth validation for feature-enhanced tracking
  115. Research Article
  116. Video tracking of swimming rodents on a reflective water surface
  117. Research Article
  118. MR imaging of model drug distribution in simulated vitreous
  119. Research Article
  120. Studying the extracellular contribution to the double wave vector diffusion-weighted signal
  121. Research Article
  122. Artifacts in field free line magnetic particle imaging in the presence of inhomogeneous and nonlinear magnetic fields
  123. Research Article
  124. Introducing a frequency-tunable magnetic particle spectrometer
  125. Research Article
  126. Imaging of aortic valve dynamics in 4D OCT
  127. Research Article
  128. Intravascular optical coherence tomography (OCT) as an additional tool for the assessment of stent structures
  129. Research Article
  130. Simple concept for a wide-field lensless digital holographic microscope using a laser diode
  131. Research Article
  132. Intraoperative identification of somato-sensory brain areas using optical imaging and standard RGB camera equipment – a feasibility study
  133. Research Article
  134. Respiratory surface motion measurement by Microsoft Kinect
  135. Research Article
  136. Improving image quality in EIT imaging by measurement of thorax excursion
  137. Research Article
  138. A clustering based dual model framework for EIT imaging: first experimental results
  139. Research Article
  140. Three-dimensional anisotropic regularization for limited angle tomography
  141. Research Article
  142. GPU-based real-time generation of large ultrasound volumes from freehand 3D sweeps
  143. Research Article
  144. Experimental computer tomograph
  145. Research Article
  146. US-tracked steered FUS in a respiratory ex vivo ovine liver phantom
  147. Research Article
  148. Contribution of brownian rotation and particle assembly polarisation to the particle response in magnetic particle spectrometry
  149. Research Article
  150. Preliminary investigations of magnetic modulated nanoparticles for microwave breast cancer detection
  151. Research Article
  152. Construction of a device for magnetic separation of superparamagnetic iron oxide nanoparticles
  153. Research Article
  154. An IHE-conform telecooperation platform supporting the treatment of dementia patients
  155. Research Article
  156. Automated respiratory therapy system based on the ARDSNet protocol with systemic perfusion control
  157. Research Article
  158. Identification of surgical instruments using UHF-RFID technology
  159. Research Article
  160. A generic concept for the development of model-guided clinical decision support systems
  161. Research Article
  162. Evaluation of local alterations in femoral bone mineral density measured via quantitative CT
  163. Research Article
  164. Creating 3D gelatin phantoms for experimental evaluation in biomedicine
  165. Research Article
  166. Influence of short-term fixation with mixed formalin or ethanol solution on the mechanical properties of human cortical bone
  167. Research Article
  168. Analysis of the release kinetics of surface-bound proteins via laser-induced fluorescence
  169. Research Article
  170. Tomographic particle image velocimetry of a water-jet for low volume harvesting of fat tissue for regenerative medicine
  171. Research Article
  172. Wireless medical sensors – context, robustness and safety
  173. Research Article
  174. Sequences for real-time magnetic particle imaging
  175. Research Article
  176. Speckle-based off-axis holographic detection for non-contact photoacoustic tomography
  177. Research Article
  178. A machine learning approach for planning valve-sparing aortic root reconstruction
  179. Research Article
  180. An in-ear pulse wave velocity measurement system using heart sounds as time reference
  181. Research Article
  182. Measuring different oxygenation levels in a blood perfusion model simulating the human head using NIRS
  183. Research Article
  184. Multisegmental fusion of the lumbar spine a curse or a blessing?
  185. Research Article
  186. Numerical analysis of the biomechanical complications accompanying the total hip replacement with NANOS-Prosthetic: bone remodelling and prosthesis migration
  187. Research Article
  188. A muscle model for hybrid muscle activation
  189. Research Article
  190. Mathematical, numerical and in-vitro investigation of cooling performance of an intra-carotid catheter for selective brain hypothermia
  191. Research Article
  192. An ideally parameterized unscented Kalman filter for the inverse problem of electrocardiography
  193. Research Article
  194. Interactive visualization of cardiac anatomy and atrial excitation for medical diagnosis and research
  195. Research Article
  196. Virtualizing clinical cases of atrial flutter in a fast marching simulation including conduction velocity and ablation scars
  197. Research Article
  198. Mesh structure-independent modeling of patient-specific atrial fiber orientation
  199. Research Article
  200. Accelerating mono-domain cardiac electrophysiology simulations using OpenCL
  201. Research Article
  202. Understanding the cellular mode of action of vernakalant using a computational model: answers and new questions
  203. Research Article
  204. A java based simulator with user interface to simulate ventilated patients
  205. Research Article
  206. Evaluation of an algorithm to choose between competing models of respiratory mechanics
  207. Research Article
  208. Numerical simulation of low-pulsation gerotor pumps for use in the pharmaceutical industry and in biomedicine
  209. Research Article
  210. Numerical and experimental flow analysis in centifluidic systems for rapid allergy screening tests
  211. Research Article
  212. Biomechanical parameter determination of scaffold-free cartilage constructs (SFCCs) with the hyperelastic material models Yeoh, Ogden and Demiray
  213. Research Article
  214. FPGA controlled artificial vascular system
  215. Research Article
  216. Simulation based investigation of source-detector configurations for non-invasive fetal pulse oximetry
  217. Research Article
  218. Test setup for characterizing the efficacy of embolic protection devices
  219. Research Article
  220. Impact of electrode geometry on force generation during functional electrical stimulation
  221. Research Article
  222. 3D-based visual physical activity assessment of children
  223. Research Article
  224. Realtime assessment of foot orientation by Accelerometers and Gyroscopes
  225. Research Article
  226. Image based reconstruction for cystoscopy
  227. Research Article
  228. Image guided surgery innovation with graduate students - a new lecture format
  229. Research Article
  230. Multichannel FES parameterization for controlling foot motion in paretic gait
  231. Research Article
  232. Smartphone supported upper limb prosthesis
  233. Research Article
  234. Use of quantitative tremor evaluation to enhance target selection during deep brain stimulation surgery for essential tremor
  235. Research Article
  236. Evaluation of adhesion promoters for Parylene C on gold metallization
  237. Research Article
  238. The influence of metallic ions from CoCr28Mo6 on the osteogenic differentiation and cytokine release of human osteoblasts
  239. Research Article
  240. Increasing the visibility of thin NITINOL vascular implants
  241. Research Article
  242. Possible reasons for early artificial bone failure in biomechanical tests of ankle arthrodesis systems
  243. Research Article
  244. Development of a bending test procedure for the characterization of flexible ECoG electrode arrays
  245. Research Article
  246. Tubular manipulators: a new concept for intracochlear positioning of an auditory prosthesis
  247. Research Article
  248. Investigation of the dynamic diameter deformation of vascular stents during fatigue testing with radial loading
  249. Research Article
  250. Electrospun vascular grafts with anti-kinking properties
  251. Research Article
  252. Integration of temperature sensors in polyimide-based thin-film electrode arrays
  253. Research Article
  254. Use cases and usability challenges for head-mounted displays in healthcare
  255. Research Article
  256. Device- and service profiles for integrated or systems based on open standards
  257. Research Article
  258. Risk management for medical devices in research projects
  259. Research Article
  260. Simulation of varying femoral attachment sites of medial patellofemoral ligament using a musculoskeletal multi-body model
  261. Research Article
  262. Does enhancing consciousness for strategic planning processes support the effectiveness of problem-based learning concepts in biomedical education?
  263. Research Article
  264. SPIO processing in macrophages for MPI: The breast cancer MPI-SNLB-concept
  265. Research Article
  266. Numerical simulations of airflow in the human pharynx of OSAHS patients
Sign up now to receive a 20% welcome discount
Institutional Access
How does access work?
Have an idea on how to improve our website?
Please write us.
© 2025 De Gruyter Brill
Downloaded on 7.9.2025 from https://www.degruyterbrill.com/document/doi/10.1515/cdbme-2015-0123/html
Scroll to top button