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Updated: Apr 15, 2026
Robotic Cochlear Implantation for Direct Cochlear Access
Published on: June 16, 2022
Manual Electrode Array Insertion Through a Robot-Assisted Minimal Invasive Cochleostomy: Feasibility and Comparison
Frederic Venail1, Brett Bell, Mohamed Akkari
1*Otology and Neurotology Department, University Hospital of Montpellier, Montpellier, France; †Institute for Neurosciences of Montpellier, INSERM U1051, Montpellier, France; ‡ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland; §Department of ENT, Head and Neck Surgery, Inselspital, University of Bern, Bern, Switzerland; and ∥Anatomy Laboratory, Faculty of Medicine, University Hospital of Montpellier, Montpellier, France.
Robot-assisted surgery enables cochlear implantation via a narrow bony tunnel. While feasible for different electrode arrays, technical improvements are needed for optimal insertion during cochlear implant surgery.
Area of Science:
- Neurosurgery
- Otolaryngology
- Medical Robotics
Background:
- Robot-assisted surgery facilitates cochlear implantation through a narrow bony tunnel (DCA) and cochleostomy.
- Previous studies support the use of free-fitting electrode arrays with this approach.
Purpose of the Study:
- To assess the feasibility and outcomes of implanting two distinct electrode arrays using a robotically assisted surgical technique.
- To investigate the compatibility of different manufacturers' electrode arrays with robot-assisted cochlear implantation.
Main Methods:
- Cone-beam CT imaging and anatomical segmentation were used to define the ideal DCA trajectory and cochleostomy placement.
- Med-El Flex 28 and Cochlear CI422 electrodes were implanted in cadaveric temporal bones.
- Post-implantation CT scans verified electrode position, and dissections assessed for anatomical damage.
Main Results:
- Successful cochlear implantation through the cochleostomy was achieved in 19 out of 20 attempts, with 90% accurate cochleostomy placement.
- No facial nerve damage was observed, with minimal deviation (0.17 ± 0.19 mm) from the planned trajectory near the facial nerve.
- Variable insertion depths were noted between the Med-El (305.5 ± 55.2 degrees) and Cochlear (243 ± 32.1 degrees) arrays.
Conclusions:
- Robot-assisted surgery proves to be a reliable method for cochlear implantation via a cochleostomy.
- Further technical advancements are required to optimize electrode array insertion in robotically assisted cochlear implant procedures.
