The Clínica Universidad de Navarra and a team of engineers from research center CEIT -IK4, at the technological campus of the University of Navarra in San Sebastian, have developed a new tool to operate on the inner ear with maximum precision, reducing possible damage to hearing function during the intervention.

It is a micromanipulator especially indicated for cochlear implant and middle ear implant operations, of which about a hundred are performed annually at the Clinic. Four engineers from CEIT-IK4 and five otorhinolaryngologists from Clínica Universidad de Navarra participated in the development of the new tool .

The new technique was presented at the XI International Symposium on Cochlear Implants, organized by the department of Otorhinolaryngology of the Clínica Universidad de Navarra, which took place in Pamplona from February 24 to 27 and was attended by attendance 200 specialists from all over the world.

This tool of work surgical has as goal "help the surgeon in those areas of small size and high sensitivity such as the inner ear, whose size does not exceed the size of a fingernail of a little finger. Working with precision in such a small space and on such a fine and delicate structure is very complicated. The micromanipulator makes it possible to intervene with precision in such a space by attaching micro-instruments for ear surgery," explains Dr. Manuel Manrique, otolaryngologist at Clínica Universidad de Navarra.

A new line of work

According to Mikel Echeverría, an engineer at CEIT-IK4, involved in the development of the new tool, the micromanipulator consists of two parts. One of them is anchored by means of a screw to the patient's temporal bone. Its function is to support a set of parts that are attached to the drilling tool . With this tool the surgeon will make the hole in the temporal bone to access the inner ear. In the center of this second set is a small metal piece that acts as a flexible mechanism. This mechanism provides the surgeon with greater control and precision in the drilling, attenuating the vibrations of the hand.

For Dr. Manrique, development of the micromanipulator is the beginning of "a new era in inner ear surgery and a new line of work". Until now, the inner ear was a frontier for the surgeon: "The inner ear was not approached because it was thought that opening it implied the loss of its function. In recent years, especially with cochlear implant surgery, we have learned to enter the inner ear without necessarily causing injury," he says.

The applications of the micromanipulator are currently focused on the field of cochlear implants and middle ear hearing implants. "But in the future," predicts the specialist, "we could eventually use it as a tool to introduce stem cells to regenerate the inner ear or to release certain drugs that offer the possibility of curing diseases that may develop in this area.