Electrode sharpness and insertion speed reduce tissue damage near high-density penetrating arrays

Objective. Over the past decade, neural electrodes have played a crucial role in bridging biological tissues with electronic and robotic devices. This study focuses on evaluating the optimal tip profile and insertion speed for effectively implanting Paradromics' high-density fine microwire arrays (FμA) prototypes into the primary visual cortex (V1) of mice and rats, addressing the challenges associated with the 'bed-of-nails' effect and tissue dimpling.Approach. Tissue response was assessed by investigating the impact of electrodes on the blood-brain barrier (BBB) and cellular damage, with a specific emphasis on tailored insertion strategies to minimize tissue disruption during electrode implantation.Main results.Electro-sharpened arrays demonstrated a marked reduction in cellular damage within 50μm of the electrode tip compared to blunt and angled arrays. Histological analysis revealed that slow insertion speeds led to greater BBB compromise than fast and pneumatic methods. Successful single-unit recordings validated the efficacy of the optimized electro-sharpened arrays in capturing neural activity.Significance.These findings underscore the critical role of tailored insertion strategies in minimizing tissue damage during electrode implantation, highlighting the suitability of electro-sharpened arrays for long-term implant applications. This research contributes to a deeper understanding of the complexities associated with high-channel-count microelectrode array implantation, emphasizing the importance of meticulous assessment and optimization of key parameters for effective integration and minimal tissue disruption. By elucidating the interplay between insertion parameters and tissue response, our study lays a strong foundation for the development of advanced implantable devices with a reduction in reactive gliosis and improved performance in neural recording applications.

Intraoperative Measurement of Insertion Speed in Cochlear Implant Surgery: A Preliminary Experience with Cochlear SmartNav

OBJECTIVES

The objectives were to present the real-time estimated values of cochlear implant (CI) electrode insertion speed (IS) during intraoperative sessions using the Cochlear Nucleus SmartNav System to assess whether this measure affected CI outcomes and to determine whether real-time feedback assists expert surgeons in achieving slow insertion.

METHODS

The IS was measured in 52 consecutive patients (65 implanted ears) using the CI632 electrode. The IS values were analyzed in relation to procedure repetition over time, NRT ratio, and CI audiological outcomes.

RESULTS

The average IS was 0.64 mm/s (SD = 0.24); minimum and maximum values were 0.23 and 1.24 mm/s, respectively. The IS significantly decreased with each array insertion by the operator (p = 0.006), and the mean decreased by 24% between the first and last third of procedures; however, this reduction fell within the error range of SmartNav for IS (+/-0.48 mm/s). No correlation was found between IS and the NRT ratio (p = 0.51), pure-tone audiometry (PTA) at CI activation (p = 0.506), and PTA (p = 0.94) or word recognition score (p = 0.231) at last evaluation.

CONCLUSIONS

The estimated IS reported by SmartNav did not result in a clinically significant reduction in insertion speed or an improvement in CI hearing outcomes. Real-time feedback of IS could potentially be used for training, but its effectiveness requires confirmation through additional studies and more accurate tools. Implementation of IS assessment in clinical practice will enable comparisons between measurement techniques and between manual and robot-assisted insertions. This will help define the optimal IS range to achieve better cochlear implant (CI) outcomes.

The relevance of threaded external skeletal fixation pin insertion speed in canine bone with and without predrilling

OBJECTIVES

The effects of insertion speed in revolutions per minute (RPM) and pilot hole predrilling for placement of threaded external skeletal fixation pins on temperature and morphological damage in cortical bone were evaluated. The null hypothesis states that insertion speed and predrilling will have no significant effect on temperature and morphological damage.

METHODS

Fixation pins were inserted into cadaveric canine femurs at speeds of 700 RPM and 150 RPM, with and without pre-drilling. Temperature was measured at each cortex 0.5 mm and 3.0 mm from each insertion site. Samples were examined grossly and by scanning electron microscopy for evidence of morphological damage. Data were analysed for maximum temperature, temperature increase, sites above thermal necrosis thresholds, microcracks, thread quality and gross damage.

RESULTS

Predrilling had a significant effect on maximum temperature, temperature increase, sites exceeding necrosis thresholds, microcracks, thread quality and gross damage. Speed of insertion had no significant effect on any of the measured parameters following predrilling, but had a significant effect on thread quality without predrilling.

CLINICAL SIGNIFICANCE

Our results fail to reject the null hypothesis concerning insertion speed, which had no significant effect on thermal damage, and minimal effect on morphological damage, which was negated by predrilling. Our results reject the null hypothesis concerning predrilling and support the practice of predrilling fixation pin insertion sites.