» Today: 25/03/2023
The 'smart' drill speeds up and simplifies cochlear implant surgery
Cochlear implantation is a complicated procedure in which some nerves can be damaged if the surgeon is not very careful. The recently developed "smart" surgical drill has a new design that can help doctors by automatically shutting down if it gets too close to those nerves.

The device is fitted with an existing image-guided, robotic assistance system in which the implant is inserted into the inner ear through a narrow channel drilled in the skull. This channel is so precisely positioned that it does absolutely no damage when it passes through the 3mm gap between the major facial nerve and the taste nerve.

Now, when this channel has been drilled a few millimeters into the skull, the drill will be withdrawn and an electrified probe will be inserted. As long as the probe doesn't get close enough to irritate the facial nerve - evidenced by facial muscle twitching - drilling can continue to go deeper.

Although using a transducer is an important step in the cochlear implant procedure, it makes the surgery longer and more laborious than it would otherwise be. This is the reason for the smart drill was born. The smart drill, designed by scientists at Switzerland's Empa Research Institute, has a titanium-nitride/silicon-nitride coated bit that simultaneously drills into the skull and generates a gentle electric current. If the electrodes on the patient's face detect stimulation of the facial nerve, the drill will stop automatically… otherwise it continues to drill.

Dr Kerstin Thorwarthm, Empa Institute said: “Our drill combines a drill and a probe, so drilling is uninterrupted and continuous monitoring is possible during the drilling process.”
It is hoped that the technology could eventually be used not only in cochlear implant surgery but also in any procedure that takes place near nerves, such as in the spine. Empa is currently looking for industry partners to help commercialize this smart drill.

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