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Soft robot-assisted drug delivery for treating inner ear pathologies


   School of Biomedical Engineering & Imaging Sciences

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  Dr Lukas Lindenroth  No more applications being accepted  Funded PhD Project (UK Students Only)

About the Project

Applications are invited for the fully funded 3,5 years full-time PhD studentship (including home tuition fees, annual stipend and consumables) starting on 1st October 2022.

Aim of the project

Drug delivery for treating pathologies of the inner ear is commonly performed manually by trained ENT surgeons. We have introduced a first proof-of-concept for a soft robot with the aim to assist in intratympanic steroid injections to improve patient comfort, de-risk the procedure and improve treatment outcomes.

In this project the student will work on the control aspects of such a soft robotic solution to achieve more efficient human-soft robot-interaction and facilitate the clinical translation of the bespoke technology. Clinical requirements for the procedure will be derived and analysed. Novel control strategies will be adopted to ensure coupling between the soft robot and its environment as well as to facilitate steering, particularly when a human operator interacts with the device. Feedback mechanisms will be employed to determine the soft robot’s state and gain insights into the efficacy of the treatment delivery with the aim to conduct trials in healthy volunteers.

Project description

It is estimated that 500 million people worldwide suffer from hearing loss [1]. It has been shown that the most effective pathway to deliver a therapeutic to the inner ear is via the middle ear cavity where the drug is deposited by perforating the tympanic membrane. Such intratympanic injections are commonly administered by trained ear, nose and throat (ENT) surgeons to avoid damage to the middle ear, which could result in permanent hearing loss. The procedures are commonly considered painful by patients despite the use of local anaesthesia and efficient monitoring of the treatment delivery is difficult.

A first proof-of-concept for a soft robotic solution has been presented in our previous research [2]. The aim of this project is to investigate new control strategies of this soft robotic solution to achieve improved steering capabilities, active stabilization and motion suppression by for example controlling the applied contact force [3], with the aim to facilitate clinical translation of the robot. For this purpose a novel, active phantom for ear interventions will be developed, control strategies for individual actuators will be derived and new feedback methods will be researched to improve controllability of membrane-actuated soft robots.

At the start of the project the student will thoroughly investigate how intratympanic injections are conducted by ENT surgeons. To generate quantifiable data such as the deviation from a desired needle insertion point on the tympanic membrane, the cumulative stress in the membrane during needle insertion or the surgeon’s tremor, a realistic, sensorized phantom will be developed based on ear reconstructions of publicly available patient datasets [4]. The phantom will be employed in a user study involving clinicians and novices to determine performance requirements for the soft robotic system, as well as in the evaluation of the soft robot. It will be equipped with load cells to measure forces applied during needle insertion, an optical tracking system to monitor needle motion as well as an active motion system to simulate disturbance during the procedure. Concise user feedback will be utilized to facilitate integration of the technology into clinical workflows as well as to improve the soft robotic system. 

The preliminary soft robot design shown in [1] comprises of membrane actuators which behave in a highly nonlinear fashion and are thus difficult to control. Employing membranes for actuation in the context of soft robotics research is still in its infancy and novel control strategies for ensuring contact between robot and environment will therefore be researched by the student.

Providing sensory feedback during the procedure is of paramount importance to determine the soft robot’s state as well as to monitor successful delivery of the steroid. The student will investigate means to efficiently sense interaction with the surgeon, which will be employed to e.g. adaptively regulate the system’s impedance to facilitate effective procedure delivery.

Finally, trials will be conducted in healthy volunteers to determine the efficacy of the proposed soft robot control methodologies to anchor and steer within the ear canal without performing needle insertion to ensure safety during trials.

References:

[1]        Piu, F. & Bishop, K. M. Local drug delivery for the treatment of neurotology disorders. Front. Cell. Neurosci. 13, 1–11 (2019).

[2]         Lindenroth, L., Bano, S., Stilli, A., Manjaly, J. G. and Stoyanov, D. A fluidic soft robot for needle guidance and motion compensation in intratympanic steroid injections. IEEE Robotics and Automation Letters, doi: 10.1109/LRA.2021.3051568.

[3]         Lindenroth L., J. Merlin, S. Bano, S., Manjaly, J., G., Mehta, N. and Stoyanov, D. Intrinsic force sensing for motion estimation in a parallel, fluidic soft robot for endoluminal interventions. IEEE Robotics and Automation Letters, 2022, doi: 10.1109/LRA.2022.3193627.

[4]         D. Sieber et al., “Data descriptor: The openEar library of 3D models of the human temporal bone based on computed tomography and micro-slicing,” Sci. Data, vol. 6, pp. 1–9, 2019.

Informal email enquiries from interested students to the supervisor are encouraged (contact details below).

Dr Lukas Lindenroth - [Email Address Removed]

Please visit KCL website for more information on eligibility criteria and application instructions.

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