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Related Experiment Video

Updated: Apr 11, 2026

Author Spotlight: Advancements in Impedance Monitoring for Cochlear Implant Surgery
06:54

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Quantifying Soft-Surgery in Cochlear Implantation: Multimodal Data From 30 International Specialists.

Philipp Aebischer1,2, Georgios Mantokoudis2, Marco Caversaccio1,2

  • 1Hearing Research Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.

The Laryngoscope
|April 10, 2026
PubMed
Summary

Surgical technique significantly impacts intracochlear mechanical stress during cochlear implantation (CI). Optimizing surgical behavior, like steady insertion and avoiding regrasping, is crucial for better hearing outcomes.

Keywords:
cochlear implantintracochlear pressuremulti‐sensor temporal bone modelsoft‐surgery technique

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Area of Science:

  • Otolaryngology
  • Biomedical Engineering
  • Surgical Science

Background:

  • Cochlear implantation (CI) is a complex procedure requiring precise surgical technique.
  • Minimizing intracochlear mechanical stress is vital for preserving residual hearing and optimizing auditory outcomes.
  • Variability in surgical behavior among specialists may lead to inconsistent outcomes.

Purpose of the Study:

  • To objectively quantify the influence of surgical behavior on intracochlear mechanical stress during CI.
  • To identify specific surgical actions associated with increased mechanical stress.
  • To correlate surgical experience and self-assessment with objective measures of surgical performance.

Main Methods:

  • Thirty specialist CI surgeons performed bilateral insertions in artificial temporal bone models.
  • Objective multi-sensor data (force, pressure, kinematics) were captured during insertions.
  • Six trauma-related metrics were combined into a composite soft-surgery score; nonparametric statistics were used for analysis.

Main Results:

  • Significant variability in surgical performance and intracochlear stress was observed.
  • Surgeons with less than 50 lifetime insertions demonstrated poorer performance.
  • Excessively slow insertions, frequent electrode regrasping, and post-insertion handling increased mechanical stress.

Conclusions:

  • Surgical behavior is a critical determinant of intracochlear mechanical stress during CI.
  • Steady, uninterrupted insertion at moderate speeds and avoidance of regrasping reduce mechanical load.
  • Structured training with quantitative feedback is essential due to unreliable self-assessment in refining surgical technique.