CBCT-guided robotic cochlear implantation precision, efficiency, and procedural standardization in a preclinical...

Area of Science:

• Neurosurgery
• Medical Robotics
• Medical Imaging

Background:

• Cochlear implantation (CI) demands submillimeter surgical precision to safeguard inner ear structures.
• Traditional CI approaches have limitations in achieving consistent precision and minimizing invasiveness.

Purpose of the Study:

• To evaluate a novel cone-beam computed tomography (CBCT)-guided robotic system for cochlear implantation (CI).
• To assess the system's potential for improving surgical precision, reducing invasiveness, and standardizing CI outcomes.

Main Methods:

• Development of a robotic system with a high-precision robotic arm and micro-drill, integrated with CBCT imaging.
• Utilized preoperative CT and intraoperative CBCT for automated pathway creation and electrode insertion guidance.
• System tested in 10 cadaveric ears for drilling accuracy and electrode placement.

Main Results:

• Successful drilling achieved in all 10 cadaveric ears, with pathways maintaining a minimum distance of 0.70 ± 0.12 mm from the facial nerve.
• Seven out of eight attempted cochlear electrode implantations were successful.
• The system demonstrated high stability, accuracy, and adaptability, accommodating individual anatomical variations.

Conclusions:

• The CBCT-guided robotic system establishes a new standard for precision and consistency in preclinical CI.
• Automating surgical steps with real-time imaging guidance reduces variability and invasiveness.
• The system shows significant potential for clinical translation, enhancing safety and reliability in robotic-assisted CI.