Meta-Analysis of Robotic Cochlear Implantation

This study aims to evaluate the outcomes of robotic cochlear implantation, focusing on audiological, anatomical, and surgical metrics, as well as safety, efficacy, and clinical benefits.

An extensive literature search was conducted in PubMed, Scopus, and Web of Science databases for studies published between January 2001 and March 2025 using the keywords "robotic cochlear implantation" and related terms. A total of 543 records were identified.

This meta-analysis was performed according to PRISMA guidelines. Studies involving human subjects, published in English, and providing sufficient patient-level data were included. After screening and eligibility evaluation, 23 studies involving 250 patients were included. Robotic approaches included full surgery, middle ear access, and electrode array insertion.

The overall success rate of robotic cochlear implantation was 97.2% (95% CI: 94.03-100.00), with low heterogeneity (I ² = 0.00%). Electrode scalar deviation and postoperative complication rates were 12.66% (95% CI: 4.82-20.51) and 11.85% (95% CI: 0.00-23.86), respectively. Residual hearing preservation was achieved in 60.69% of patients (95% CI: 23.21-98.18), though with considerable heterogeneity (I ² = 98.41%). Subgroup analyses revealed that scalar deviation was more frequent in robotic electrode insertion (17.11%) than in robotic middle ear access (6.43%).

Robotic cochlear implantation in either way demonstrates reliability, surgical precision, and potential advantages in hearing preservation. Greater attention should be given to minimizing the rate of scalar deviation. Advanced and more precise technologies are required to achieve optimal surgical outcomes in robotic cochlear implantation. Additional long-term studies are needed to confirm these results and support their broader applicability.

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