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Updated: Mar 14, 2026
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Robotic Cochlear Implantation for Direct Cochlear Access
Published on: June 16, 2022
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Improvement of the insertion axis for cochlear implantation with a robot-based system
Renato Torres1,2, Guillaume Kazmitcheff1,3, Daniele De Seta1,2
1Sorbonne Universités, Université Pierre et Marie Curie Paris 6 (UPMC Paris 6), Inserm, UMR-S 1159 Réhabilitation chirurgicale mini-invasive et robotisée de l'audition, 16, rue Henri Huchard, 75018, Paris, France.
Summary
Technological assistance, particularly semi-automated robot systems, significantly improves cochlear implant insertion accuracy. Manual and navigation-assisted methods showed higher errors, while robot assistance reduced variability for better cochlear implantation outcomes.
Area of Science:
- Otorhinolaryngology
- Medical Robotics
- Surgical Navigation
Background:
- Cochlear implantation accuracy is traditionally dependent on surgeon experience.
- Precise alignment of the insertion axis is crucial for optimal outcomes and avoiding complications.
Purpose of the Study:
- To evaluate the efficacy of technological aids in improving insertion axis accuracy during cochlear implantation.
- To compare manual, navigation-assisted, and robot-assisted insertion techniques.
Main Methods:
- Four human temporal bones were used for experimental procedures.
- Techniques included manual, manual navigation-assisted, robot-based navigation-assisted, and robot-based semi-automated insertion.
- Preoperative cone beam CT and neuronavigation were utilized. Insertion axis error was measured against an optimal axis defined to avoid the facial nerve and target the scala tympani centerline.
Main Results:
- The semi-automated robot-based technique demonstrated the highest accuracy with the lowest error (3.4° ± 1.56°).
- Manual (8.3° ± 2.82°) and manual navigation-assisted (8.6° ± 2.83°) procedures showed significantly higher errors.
- Robot-based navigation-assisted insertion yielded an error of 5.4° ± 3.91°.
Conclusions:
- Semi-automated robot-based systems significantly enhance cochlear implantation insertion accuracy compared to manual methods.
- Current neuronavigation systems combined with manual insertion do not improve accuracy due to interface limitations.
- Robot-assisted systems offer reduced error and variability, potentially improving surgical precision in cochlear implantation.
