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Impedance and Functional Outcomes in Robotic-Assisted or Manual Cochlear Implantation: A Comparative Study.

Guillaume Gersdorff1, Nicolas Peigneux1, Unal Duran2

  • 1Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Liège University, CHU de Liège, Liège, Belgium.

Audiology & Neuro-Otology
|August 25, 2024
PubMed
Summary

Robotic-assisted cochlear implantation using RobOtol® resulted in less hearing loss and improved impedance stability. This atraumatic insertion technique enhances auditory performance, particularly in cases with complete residual hearing preservation.

Keywords:
Cochlear implantsHearing preservationImpedanceRobot-assisted surgery

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Area of Science:

  • Otorhinolaryngology
  • Neurosurgery
  • Biomedical Engineering

Background:

  • Cochlear implantation aims to preserve residual hearing, especially low frequencies, through electroacoustic stimulation.
  • Minimally invasive and robotic-assisted surgery improve electrode array insertion.
  • Foreign body insertion can cause fibrous tissue, osteogenesis, elevated impedance, and reduced word comprehension.

Purpose of the Study:

  • To evaluate the impact of RobOtol® on impedance changes over time.
  • To assess the functional outcomes of robotic-assisted cochlear implantation.
  • To compare auditory performance between manual and robotic insertion methods.

Main Methods:

  • Cochlear implant surgery with round window approach.
  • Insertion of Med-El Flex24 electrode arrays manually (15) and with RobOtol® (24).
  • Pure-tone audiometry and word recognition scores assessed up to 1 year post-surgery.

Main Results:

  • Robotic insertion led to less significant low-frequency hearing loss (41.67% vs. 53.33%).
  • Robotic surgery showed reduced impedance variability, a decreasing trend, and lower values with complete hearing preservation.
  • Favorable speech intelligibility evolution observed with complete hearing preservation; robotic surgery showed continued improvement beyond 6 months when hearing was not preserved.

Conclusions:

  • Robotic-assisted atraumatic insertion with RobOtol® minimizes inner ear disturbances.
  • This technique leads to better auditory performance and impedance stability.
  • Consistent, slow insertion speed is key for preserving neurosensory structures.