Active surgical positioning device for a cochlear implant electrode array

Cochlear implants have been of great benefit in restoring auditory function to individuals with profound bilateral sensorineural deafness. The implants are used to directly stimulate auditory nerves and send a signal to the brain that is then interpreted as sound. This project focuses on the development of a surgical positioning tool to accurately and effectively place an array of stimulating electrodes deep within the cochlea. This will lead to improved efficiency and performance of the stimulating electrodes, reduced surgical trauma to the cochlea, and as a result, improved overall performance to the implant recipient. The positioning tool reported here consists of multiple fluidic chambers providing localized curvature control along the length of the attached silicon electrode array. The chambers consist of 200μm inner diameter PET (polyethylene therephthalate) tubes with 4μm wall thickness. The chambers are molded in a tapered helical configuration to correspond to the cochlear shape upon relaxation of the actuators. This ensures that the optimal electrode placement within the cochlea is retained after the positioning tool becomes dormant (for chronic implants). Actuation is achieved by injecting fluid into the PET chambers and regulating the fluidic pressure. The chambers are arranged in a stacked, overlapping design to provide fluid connectivity with the non-implantable pressure controller and allow for local curvature control of the device. The stacked tube configuration allows for localized curvature control of various areas along the length of the electrode and additional stiffening and actuating power towards the base. Curvature is affected along the entire length of a chamber and the result is cumulative in sections of multiple chambers. The actuating chambers are bonded to the back of a silicon electrode array.

Selective matrix remodeling to increase interstitial flow in lymphedema

Lymphedema is a disease characterized by swelling resulting from the accumulation of fluid in the extracellular matrix (ECM) of the skin. In order to alleviate this swelling, the authors sought to selectively degrade certain hydrophilic molecules in the ECM called glycosaminoglycans (GAGs). GAGs are long unbranched sugar molecules present in the ECM that attract water to their numerous negative charges. The authors hypothesized that the density of GAGs would increase in lymphedema and inhibit fluid from leaving the tissue. An existing mouse tail model of experimental lymphedema that reproduced important features of the human condition was used to evaluate GAG content in swollen tissue. In this model, a surgical excision of tissue was made circumferentially around the tail that caused swelling distal to the wound site. Tissue distal to the wound site was analyzed via two assays; one that measured hyaluronan (an unsulfated GAG) and another that measured sulfated GAGs (including Dermatan Sulfate and Chondroitin Sulfate), at various timepoints post surgical intervention. Hyaluronan (HA) levels were significantly higher than control (tissues with no surgical intervention) by day 5 (p