Cochlear implant surgery using the 4 K-three-dimensional exoscope ORBEYE: a comparative study with conventional...

Area of Science:

• Otolaryngology
• Surgical Technology
• Medical Devices

Background:

• Cochlear implant (CI) surgery requires advanced visualization techniques.
• The operating microscope (OM) is the conventional tool, but newer technologies are emerging.
• Exoscopes offer high-resolution 3D visualization, potentially improving surgical procedures.

Purpose of the Study:

• To assess the feasibility of the 4K-3D exoscope ORBEYE (ExS) in CI surgery.
• To compare the ExS with the conventional OM regarding surgical outcomes, complications, and hearing results.
• To evaluate surgeon preferences and performance aspects of both visualization systems.

Main Methods:

• Retrospective analysis of 77 CI surgeries (42 ExS, 35 OM).
• Comparison of surgical outcomes, complications, and hearing results.
• Questionnaire-based evaluation by eight otologists on technical and operative performance, team interaction, and procedure-specific aspects.

Main Results:

• ExS surgeries were completed successfully; operative time was longer in the ExS group (162 vs. 130 min), potentially due to higher resident participation.
• Excluding resident-led mastoidectomies, operative times were comparable (152 vs. 130.5 min).
• Hospital stay, complication rates, and hearing improvements were similar for both systems. Surgeons preferred ExS in most domains, citing advantages in implant bed creation, cochleostomy, and electrode insertion.

Conclusions:

• The 4K-3D ExS ORBEYE is a viable alternative to OM for CI surgery, yielding comparable surgical outcomes.
• Extended operative times with ExS may be attributed to educational benefits rather than technical limitations.
• ExS demonstrates advantages in team interaction and surgical education, enhancing the CI surgical experience.