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Updated: May 27, 2026

Robotic Cochlear Implantation for Direct Cochlear Access
Published on: June 16, 2022
Keyhole cochlear implantation: current status
1Department of Otolaryngology, Royal Children's Hospital, and University of Queensland, Brisbane, Australia. bruceblackmd@bigpond.com
Introduction:
Past cochlear implantation (CI) techniques have included a variety of soft tissue and bony trauma to place and stabilize the implant body. Despite minimalist approaches, the surgery invites further refinement.
Materials And Methods:
A restricted access "keyhole" CI technique was developed through a series of 547 cases undertaken from 1997. The surgery used a 20-mm-diameter mini C-incision on the rear of the auricle and avoided the use of a bony retention well or suture fixation. Initial body migration rates were successfully countered using small titanium mesh "bridges." The series was free from other problems specific to the technique.
Discussion:
The study demonstrates that CI can be performed with only restricted exposure, disposing of well and suture fixation methods, and without a wound that may be adjacent to the implant body or electrode arrays.
Conclusion:
The keyhole approach proved atraumatic and brief. It is particularly suited to simultaneous bilateral implantation in the infant and proved adaptable to all ages.