Related Experiment Video
Updated: May 10, 2026

Robotic Cochlear Implantation for Direct Cochlear Access
Published on: June 16, 2022
A minimally invasive technique for the implantation of bone-anchored hearing devices
1Wilson Ear Clinic, Portland, Oregon 97209, USA.
Objective:
To describe and evaluate a novel technique for the implantation of bone conduction hearing devices as compared with a common, conventional technique.
Study Design:
Case series with chart review.
Setting:
Tertiary referral otology and neurotology practice.
Methods:
Individuals who underwent the implantation of bone-anchored hearing devices between January 1, 2004, and December 31, 2011, were identified. Demographic data, surgical indications, surgical technique used, surgical time, and complications were recorded. Soft tissue complications were graded on the Holgers classification scheme. Group 1 was defined as those undergoing a traditional technique using a dermatome with subcutaneous tissue reduction. Group 2 was defined as those undergoing the described technique for implantation of the coupling hardware with minimal subcutaneous soft tissue reduction.
Results:
Forty patients underwent the procedure, with 11 patients comprising group 1 and 29 patients comprising group 2. Group 2 required a shorter operative time (32.3 vs 56.1 minutes, P < .0001). Of patients in group 1, 2 of 11 developed soft tissue complications, whereas 5 of 29 in group 2 developed soft tissue complications (P = 1.000). Most soft tissue complications were reversed with conservative wound care.
Conclusion:
Surgery was performed faster with similar postoperative outcomes in individuals undergoing implantation of bone-anchored hearing devices using the described technique that necessitated minimal soft tissue reduction.

