Next-generation Robotics in Otology: The HEARO Procedure

Area of Science:

• Neurosurgery
• Biomedical Engineering
• Otolaryngology

Background:

• Hearing impairment is a common disability globally, with cochlear implantation being the most effective neural prosthesis.
• Minimally invasive techniques are crucial for cochlear array placement to preserve hearing across all frequencies.
• Robotically Assisted Cochlear Implantation Surgery (RACIS) aims to enhance precision in robotic inner ear access.

Purpose of the Study:

• To evaluate the viability and precision of the HEARO method for robotic inner ear access in cochlear implantation.
• To assess a novel technology for personalized robotic inner ear access in a cadaveric model.

Main Methods:

• 3D reconstruction of auditory canal, facial nerve, and other critical anatomical structures.
• Development and application of the HEARO method for robotic cochlear array insertion.
• Measurement of trajectory and distance to the facial nerve and chorda tympani.

Main Results:

• The HEARO method achieved a 94% mean insertion percentage in 9 out of 10 procedures.
• No collisions or damage to vital anatomical structures were observed during the robotic procedures.
• The mean intended distance to the chorda tympani and facial nerve was successfully maintained.

Conclusions:

• The HEARO method demonstrates feasibility and precision for robotic cochlear implantation.
• Future RACIS systems will incorporate haptic feedback, automated planning, and advanced imaging.
• This technology holds potential for improved outcomes in cochlear implantation surgery.