Earable tooth-click control helps neurosurgeons operate hands-free
NeuroClick: Preserving Surgeon Autonomy through Hands-Free Earable Tooth-Click Control in Neurosurgery
Human-Computer Interaction
Summary
Operating rooms can be challenging for neurosurgeons because their hands are busy and must stay sterile, making it hard to control equipment. The authors introduced a tiny device worn on the ear that listens for special tooth-click sounds to control devices hands-free. They trained a computer program to recognize these clicks with very high accuracy and tested it with real neurosurgeons during a simulated surgery. Surgeons said it was easy to use and felt safe, and it helped them control the surgical microscope without relying on an assistant all the time.
What this means in practice
- •For operating room technology teams: Integrate tooth-click earable devices into neurosurgery equipment to provide hands-free microscope controls, reducing surgeon distraction and reliance on assistants.
- •For robotic surgery system developers: Develop hands-free control methods using tooth-click input to operate surgical tools or robots in sterile environments with minimal interruption.
Authors
Jonas Hummel, Maximilian Burzer, Clara Sayffaerth, Valeria Zitz, Amir El Rahal, Michael Küttner, Tobias Röddiger, Jürgen Beck, Michael Beigl
Abstract
Neurosurgeons frequently interact with operating room (OR) technologies while sterility and occupied hands constrain control. We introduce earables as a direct, hands-free control platform for neurosurgery using tooth-click input. Formative OR observations and interviews with 10 domain experts grounded the design. Using OpenEarable 2.0 data from 12 participants, we developed a real-time recognition pipeline whose classifier achieved a median macro F1-score of 98.6% under leave-one-subject-out cross-validation. We evaluated the technique with 20 neurosurgeons during a simulated resection task in a neurosurgical OR. Participants reported few focus shifts and rated Earable favorably for workflow integration and perceived safety. Autonomous microscope control was rated significantly higher with Earable than Delegation, whereas Delegation enabled faster task completion under continuous assistant availability. Workload, usability, and task errors showed no significant differences. Preferences depended on training, reliability, context, and assistant availability. Earables thus add a direct, hands-free option for controlling selected functions alongside established workflows.