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Updated: May 9, 2026
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Robotic Cochlear Implantation for Direct Cochlear Access
Published on: June 16, 2022
In vitro accuracy evaluation of image-guided robot system for direct cochlear access
Brett Bell1, Nicolas Gerber, Tom Williamson
1ARTORG Center for Biomedical Engineering, Inselspital, University of Bern, Bern, Switzerland. brett.bell@artorg.unibe.ch
Summary
This study demonstrates an improved image-guided robotic system for direct cochlear access (DCA) surgery, achieving high accuracy in cadaver models for cochlear electrode insertion.
Area of Science:
- Neurosurgery
- Robotic Surgery
- Medical Imaging
Background:
- Direct cochlear access (DCA) offers a minimally invasive approach for cochlear electrode insertion.
- Accurate navigation through the narrow facial recess is critical for DCA.
- Previous robotic systems utilized patient-specific templates for guidance.
Purpose of the Study:
- To report improvements in an image-guided surgical robot system for DCA.
- To evaluate the accuracy of the enhanced robotic system in vitro.
- To assess the feasibility of robotic DCA for cochlear implantation.
Main Methods:
- Bilateral robotic DCA performed on 4 cadaver specimens.
- Image-guided navigation using cone-beam CT and custom software for planning.
- Drill trajectory accuracy assessed by comparing planned and actual tunnel paths.
Main Results:
- Low drilling errors achieved: 0.08 ± 0.05 mm at the mastoid surface and 0.15 ± 0.08 mm at the round window.
- Successful full cochlear electrode insertion in 7 out of 8 cases.
- Demonstrated feasibility of the robotic workflow for clinical application.
Conclusions:
- The improved image-guided robot system enables safe and reliable DCA.
- The developed workflow supports potential future clinical implementation of robotic cochlear implantation.
- This technology represents a viable alternative to conventional mastoidectomy.
