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Updated: Oct 7, 2025

Robotic Cochlear Implantation for Direct Cochlear Access
Published on: June 16, 2022
A three-dimensional exoscope system for bilateral simultaneous cochlear implant surgery: how I do it
S H Tan1, J Kulasegarah1, N Prepageran1
1Department of Otolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Background:
This paper reports the first case of simultaneous bilateral cochlear implant surgery performed exclusively with a three-dimensional exoscope. It also discusses the optimum operative set-up and the feasibility of three-dimensional exoscopic ear surgery as an alternative to the microscope.
Method:
The Vitom three-dimensional exoscope system (Karl Storz) was used.
Results:
The surgery was successfully completed, with no peri-operative complications. Both the operation time and the surgical outcome for the patient were comparable with the previous cochlear implant surgical procedures performed in our centre using the conventional operating microscope.
Conclusion:
This paper demonstrates that exclusive use of the three-dimensional exoscope is a viable alternative to the operating microscope for selected otological cases. It is clear that the three-dimensional exoscopic technique is potentially very promising for future surgical procedures, provided that cases are selected carefully to prevent compromising exposure, efficiency or patient safety.

