Fluidic soft robot for needle guidance and motion compensation for intratympanic steroid injections

用于鼓室内类固醇注射的针引导和运动补偿的流体软机器人

• 批准号: 2724123
• 金额: --
• 依托单位: University College London
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2724123
• 关键词: Fluidic; soft; robot; needle; guidance

1. The World Health organization estimates that hearing loss affects 500 million people worldwide. Delivery of drugs to the inner ear via the surgical approach offers the optimum delivery of drugs to the cochlea. However, it poses risks, such as further reduction in hearing due to the highly invasiveness. Therefore, in most cases administration of drugs through diffusion to the inner ear from the middle ear is the preferred option, which is done in the intratympanic injection of steroids, where flushing of steroids to the middle ear through the ear drum is done, with uncertainty of the treatment's efficiency. This is currently performed by trained ear, nose, and throat (ENT) surgeons as the procedure could induce pain to the patient and pose the risk of inducing permanent hearing loss, vertigo, or tinnitus, if the inner or middle ear is damaged. In recent years, the emergence of technologies for diagnosis and treatment through natural orifices has been exponentially growing. However, the morphology of the ear orifice presents a major challenge for its adoption in this field due to its small dimension, fragility, and highly non-uniform shape. To provide a first steppingstone towards inner ear drug delivery, a fluidic soft robot for needle guidance and motion compensation has been introduced for intratympanic steroid injections. The design constitutes of a camera and six integrated fluidic actuators that is capable in stabilising, translating and rotating of a given needle within a lumen. This system indeed could provide needle guidance towards desired target while reducing needle motion. However, whilst it shows the capability to aid in drug delivery into the middle ear cavity, the current design inherits several limitations which prevent it from targeted delivery directly to the cochlea. 2. Further research needs to be undertaken to better understand state-of-the-art drug delivery mechanisms, develop means for efficient monitoring of the delivery and integrate this with bespoke soft robotic system. 3. As part of this project, I will develop new, realistic and sensorized phantoms which can provide quantitative assessment of today's manual delivery and determine the efficacy of local drug delivery to the inner ear. As current state-of-the-art endoscope systems are incapable of visualizing the middle ear cavity through the ear drum, which is crucial in determining the efficacy of drug delivery to the inner ear, I will research new means of imaging the ear anatomy, for example by using endoscopic vision paired with near-infrared or narrow-band imaging. The gained understanding of the procedure and the derived imaging methodologies will be incorporated in a soft robotic platform inspired by to aid in delivery and monitoring the efficacy of the delivery whilst ensuring patient safety and comfort and greatly de-risking the procedure. 4. This interdisciplinary research track combines aspects from biomedical engineering, medical imaging and image computing and soft robotics, which could pave the way for democratizing drug delivery to the inner ear. Furthering the understanding of current clinical practices could aid in developing new delivery protocols and provide training for ENT surgeons or other clinical staff which could lead to the more widespread adoption of treatment for inner ear pathologies. Novel imaging capabilities for visualizing the middle ear cavity to assess drug delivery to the inner ear are of paramount importance in drug discovery and assessment for treating inner ear pathologies. Finally, the integration with a soft robotic system could greatly de-risk and de-skill such drug delivery protocols with the potential to enable other ENT procedures. These are all alligned with EPSRC' strategy and research area on transforming health and healthcare, improving quality of life through innovative technological solutions.5. WEISS and UCL EAR institute.

1. 世界卫生组织估计，听力损失影响着全球5亿人。通过手术途径将药物输送到内耳提供了最佳的药物输送到耳蜗。然而，它也带来了风险，如由于高度侵入性而导致听力进一步下降。因此，在大多数情况下，药物从中耳扩散到内耳是首选，这是在鼓膜内注射类固醇，其中类固醇通过鼓膜冲洗到中耳，治疗效率不确定。目前，这种手术是由训练有素的耳鼻喉外科医生进行的，因为如果内耳或中耳受损，该手术可能会给患者带来疼痛，并可能导致永久性听力丧失、眩晕或耳鸣。近年来，通过自然孔口进行诊断和治疗的技术呈指数级增长。然而，耳孔的形态由于其尺寸小、易碎和高度不均匀的形状，对其在该领域的应用提出了重大挑战。为了给内耳给药提供第一个垫脚石，一种用于鼓室内类固醇注射的液体软机器人用于针头引导和运动补偿。该设计由一个摄像头和六个集成流体致动器组成，能够在流腔内稳定，平移和旋转给定的针。该系统确实可以在减少针的运动的同时提供指向目标的针导向。然而，虽然它显示出了帮助药物进入中耳腔的能力，但目前的设计继承了一些限制，这些限制阻止了它直接靶向递送到耳蜗。2. 需要进行进一步的研究，以更好地了解最先进的药物输送机制，开发有效监测输送的方法，并将其与定制的软机器人系统集成。3. 作为这个项目的一部分，我将开发新的、真实的、感测的幻影，它可以对今天的人工给药提供定量评估，并确定局部给药到内耳的效果。由于目前最先进的内窥镜系统无法通过鼓膜看到中耳腔，而这对于确定内耳给药效果至关重要，因此我将研究新的耳部解剖成像手段，例如使用内窥镜视觉与近红外或窄带成像相结合。获得的程序和衍生成像方法的理解将被纳入一个软机器人平台的启发，以帮助交付和监测交付的有效性，同时确保患者的安全和舒适，并大大降低风险的过程。4. 这个跨学科的研究轨道结合了生物医学工程、医学成像和图像计算以及软机器人等方面，这可能为内耳药物输送的民主化铺平道路。进一步了解当前的临床实践有助于制定新的分娩方案，并为耳鼻喉外科医生或其他临床工作人员提供培训，从而更广泛地采用内耳病理治疗。通过中耳腔可视化来评估内耳药物输送的新型成像能力对于内耳疾病的药物发现和评估具有至关重要的意义。最后，与软机器人系统的集成可以极大地降低这种药物输送方案的风险和技能，并有可能使其他耳鼻喉科手术成为可能。这些都符合EPSRC的战略和研究领域，即通过创新的技术解决方案来改变健康和医疗保健，提高生活质量。WEISS和UCL EAR研究所。