SGER: Exploratory Research in Device Development for Robot Assisted Image Guided Needle Access of Cochlea

目前，耳科外科医生无法在不造成耳蜗和前庭功能不可逆损伤的情况下对内耳进行手术。这种限制从根本上限制了我们理解、诊断和治疗内耳疾病（如听力损失和眩晕）的能力。这个探索性研究项目旨在开发和测试一个“概念验证”的实时耳蜗成像系统，该系统将使用机器人辅助，为精确和自动地将微针植入内耳的隔间提供导航。该系统将由一个机器人末端执行器组成，该末端执行器结合了一个70 MHz聚焦光束超声换能器和一个直径110微米的微针。末端执行器将以两个自由度驱动，安装在机械臂上，以获取二维平面和三维体积超声图像，并插入和收回微针。智力优势：提出的机器人设备将是第一个能够(a)执行耳蜗实时超声成像和(b)利用这些图像将图像引导针置入耳蜗腔室的系统。该系统将使目前认为不可能的活体耳科研究成为可能。提出的SGER将使我们能够进行必要的基础研究，以开发一个实时机器人图像引导干预系统。更广泛的影响：对耳蜗内膜进行实时活体成像的能力，以及在耳蜗内以最小的创伤精确放置工具和传感器的能力，将为内耳疾病的诊断和治疗开辟新的途径。例如，在耳蜗内放置传感器，将允许对耳蜗内的代谢变化进行实时光谱评估，从而为耳蜗病理生理学的研究提供新的思路。在未来，在内耳内放置针头将允许直接递送治疗化合物来治疗耳蜗疾病，包括药物、基因治疗载体和干细胞治疗

At present, otologic surgeons are unable to perform surgical procedures on the inner ear without rendering irreversible injury to cochlear and vestibular function. This limitation fundamentally constrains our ability to understand, diagnose, and treat inner ear disorders such as hearing loss and vertigo. This exploratory research program seeks to develop and test a "proof of concept" real-time cochlear imaging system that will provide navigation for the precise and atraumatic placement of micro-needles into compartments of the inner ear using robotic assistance. The system will consist of a robotic end-effector combining a 70 MHz focused-beam ultrasonic transducer with a 110 micron diameter micro-needle. The end-effector will be actuated in two degrees-of-freedom and mounted on a robotic arm to acquire both 2-D planar and 3-D volumetric ultrasonic images, and to insert and retract the micro-needle. Intellectual Merit: The proposed robotic device will be the first system capable of (a) performing real-time ultrasonic imaging of the cochlea and (b) employing these images for image-guided needle placement into the compartments of the cochlea. The proposed system will enable in vivo otologic research presently considered impossible. The proposed SGER will enable us to do the basic research necessary to develop a working real-time robotic image guided intervention system. Broader Impact: The ability to perform real-time in vivo imaging of the intracochlear membranes and to place precisely tools and sensors within the cochlea with minimal trauma would open new avenues for the diagnosis and treatment of inner ear disorders. The intracochlear placement of sensors for example, would allow real-time spectrographic assessment of metabolic changes inside the cochlea, enabling new lines of research into cochlear pathophysiology. In the future, the placement of needles within the inner ear would permit the direct delivery of therapeutic compounds to treat cochlear disease, including medications, gene therapy vectors and stem cell therapy