Objectives: For minimally invasive drilling processes, the temperature development in the drilling ground is of crucial importance for patient safety. This is particularly important for the concept of single port cochlear implantation in a pediatric population as temperature-sensitive structures need to be passed and the morphology of the temporal bone can be more challenging. To monitor the temperature during drilling, a drill prototype was developed in our group, which can record the drill temperature in real time. The prototype must be refined for use in the operating room, as the drill does not yet meet all the medical requirements that need to be fulfilled. In further development, the recorded temperature data must be processed and communicated to the surgeon to provide added value for the patients safety.
Methods: We identified several topics in the current system that need to be adapted in order for the system to be useable in the operating room. We hereby present the current system and the necessary changes.
Results: The prototype has limitations such as a diameter of 5 mm, which cannot be applied in lateral skull base surgery. The first rework aims to integrate the sensor in a drill of 1.6 mm as well as selecting a drill geometry that generates low heat. A literature review has been conducted to summarize the effects of each geometry parameter on heat generation and systematic analysis was performed to select the most optimized drill geometry. The positively evaluated drills will be subject to detailed investigation in further studies and the drill that meets medical requirements and generates the least heat will be used for further development. In addition there is the need to further optimize the energy supply to the sensor system and the communication of the data to the user with AI-generated recommendations for action, e.g. to lower the feed rate when a critical rise in temperature is expected.
Conclusion: After successful implementation of the refinements, this technology will make a valuable contribution to the understanding of the drill temperature during medical drilling processes in order to make key-hole approaches in the lateral skull base safer.

Temperature-control for minimal invasive drilling in the lateral skull base: refinement of a drill with integrated temperature sensor technology and implications for pediatric CI

It is with great pleasure and enthusiasm, that on behalf of the Cochlear Implant centers of the Radboud UMC in Nijmegen and Erasmus MC Sophia Children’s Hospital in Rotterdam to invite you to attend the 16th European Symposium on Pediatric Cochlear Implantation to Rotterdam, the Netherlands in 2023.

Yours sincerely, on behalf of the CI Centers at Radboud UMC and Erasmus MC,