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Author Spotlight: Optimizing EAS with Long Electrodes for Enhanced Cochlear Coverage and Hearing Preservation
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Robotic-Assisted Electrode Array Insertion Improves Stability of Acoustic Hearing Thresholds.

Uzair A Khan1, Rachel A Scheperle1, Grant Podhajsky2

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Summary

Robotic-assisted electrode array insertion significantly reduces delayed-onset hearing loss after cochlear implant surgery. This advanced technique helps preserve residual acoustic hearing, a key goal in CI procedures.

Keywords:
cochlear implantdelayed‐onset hearing losshearing preservationrobotic‐assisted insertion

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Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Medical Robotics

Background:

  • Preserving residual acoustic hearing is crucial in cochlear implant (CI) surgery.
  • Delayed-onset hearing loss (DOHL) can negatively impact CI outcomes.
  • Robotic-assisted electrode array (EA) insertion is an emerging technique for CI surgery.

Purpose of the Study:

  • To evaluate the impact of robotic-assisted EA insertion on DOHL rates.
  • To compare DOHL incidence between manual and robotic-assisted CI procedures.
  • To assess the efficacy of robotic assistance in preserving hearing post-CI.

Main Methods:

  • A comparative study involving adult patients undergoing CI surgery.
  • Sixty patients received manual EA insertion, while 29 underwent robotic-assisted insertion (iotaSOFT system).
  • Longitudinal changes in low-frequency pure-tone average (LFPTA) were tracked to define DOHL (>10 dB decrease).

Main Results:

  • DOHL occurred in 37% of the manual cohort vs. 7% in the robotic-assisted cohort (p=0.002).
  • At 12 months, DOHL was observed in 29% of the manual group versus 0% in the robotic group (p=0.011).
  • The number needed to treat with robotic assistance to prevent DOHL was 4.

Conclusions:

  • Robotic-assisted EA insertion significantly reduces the incidence of DOHL.
  • This technique offers a clinically meaningful improvement in preserving residual acoustic hearing.
  • Robotic assistance is a valuable tool for achieving hearing preservation goals in CI surgery.