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Updated: Jul 29, 2025

Robotic Cochlear Implantation for Direct Cochlear Access
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True keyhole cochlear implant surgery.

Jaouad Abari1, Emilie Heuninck1, Mohammad Al Saadi1

  • 1Department of Otorhinolaryngology Head and Neck Surgery, University Hospital UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium.

American Journal of Otolaryngology
|May 25, 2023
PubMed
Summary
This summary is machine-generated.

Robotic assisted cochlear implant surgery (RACIS) now allows electrode insertion without opening the tympanomeatal flap. This image-guided approach enhances minimal invasiveness in cochlear implantation.

Keywords:
Cochlear implantationImage-guided surgeryRobot-assisted cochlear implant surgerySensorineural hearing loss

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Area of Science:

  • Otolaryngology
  • Medical Robotics
  • Surgical Navigation

Background:

  • Conventional cochlear implantation often requires a tympanomeatal flap, which is not minimal invasive.
  • Robotic Assisted Cochlear Implant Surgery (RACIS) is a keyhole procedure, limiting direct visualization of electrode insertion.
  • Existing methods visualize the round window via the external auditory canal, necessitating tympanic membrane manipulation.

Observation:

  • This study reports the first experience of robotic cochlear implantation surgery utilizing image guidance.
  • The procedure was performed without opening a tympanomeatal flap for electrode insertion.
  • A straight, flexible lateral wall electrode was used in the RACIS procedure.

Findings:

  • Successful electrode insertion into the scala tympani was achieved using image guidance and robotic assistance.
  • The study refined insertion angles and planning software for accurate round window approaches.
  • A new clinical routine for electrode insertion in RACIS without a tympanomeatal flap was established after 33 cases.

Implications:

  • This technique advances minimally invasive cochlear implant surgery.
  • Image-guided RACIS offers a less invasive alternative for electrode insertion.
  • The developed routine may improve patient outcomes and surgical efficiency in cochlear implantation.