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Robotic Cochlear Implantation for Direct Cochlear Access
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Robot-assisted Cochlear Implant Electrode Array Insertion in Adults: A Comparative Study With Manual Insertion.

Hannah Daoudi1,2, Ghizlene Lahlou1,2, Renato Torres3,2

  • 1Sorbonne University/AP-HP, GHU Pitié-Salpêtrière, DMU ChIR, Department of Oto-Rhino-Laryngology, Unit of Audiology, Auditory Implants and skull base surgery.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|December 11, 2020
PubMed
Summary

Robot-assisted cochlear implantation using the RobOtol technique demonstrated safe and reliable insertion of various electrode arrays. Straight electrode arrays showed significantly fewer scalar translocations with robotic assistance compared to manual insertion.

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Area of Science:

  • Otolaryngology
  • Medical Robotics
  • Neurosurgery

Background:

  • Cochlear implantation is a standard treatment for severe to profound sensorineural hearing loss.
  • Accurate electrode array insertion into the cochlea is crucial for optimal hearing outcomes.
  • Minimizing trauma during insertion is a key goal in cochlear implant surgery.

Purpose of the Study:

  • To evaluate the safety and efficacy of robot-assisted cochlear array insertion.
  • To compare outcomes of robot-assisted insertion with manual insertion for different electrode array types.
  • To assess the rate and location of scalar translocations in both techniques.

Main Methods:

  • Retrospective review of 20 robot-assisted (RobOtol) and 40 manual cochlear implantations.
  • Analysis of straight and precurved electrode arrays (Cochlear CI522/622, Advanced Bionics Hifocus Slim J, Advanced Bionics Hifocus Mid-Scala).
  • Three-dimensional reconstruction from CT scans to evaluate basilar membrane and electrode array position.

Main Results:

  • Robot-assisted insertion of straight arrays resulted in 19% scalar translocations versus 31% for manual insertion.
  • The percentage of translocated electrodes was significantly lower with robot-assisted insertion (7%) compared to manual (16%) (p < 0.0001).
  • For precurved arrays, scalar translocations were 50% in the robot-assisted group and 38% in the manual group.

Conclusions:

  • Robot-assisted cochlear array insertion is safe and reliable for various electrode types.
  • Robotic insertion of straight electrode arrays leads to less trauma than manual insertion.
  • Further research may optimize robot-assisted techniques for precurved arrays.