Robotic Cochlear Implantation: The future

Abstract

Objective: To report the first case of robotic cochlear implantation within a clinical setting.Material and methods: A clinical workflow for use of a system for robotic cochlear implantation was developed. Based on preoperative images, a safe trajectory to the round window was planned and drilled by the robotic system. Intraoperatively the drill path was assessed using imaging and sensor-based data to confirm safety of the facial nerve. Electrode array insertion was manually performed. Drilling accuracy and electrode array placement were assessed using postoperative CT images.Results: Robotic drilling was conducted with an accuracy of 0.2 mm. The approach resulted in a minimal mastoidectomy and minimal incisions. Manual electrode array insertion was successfully performed through the robotically drilled tunnel. The procedure was performed without complications and all surrounding structures were preserved.Discussion: The first case of robotic cochlear implantation was demonstrated to be feasible and safe. Further cases are evaluated as part of the currently undergoing clinical trial.Conclusion: Robotic cochlear implantation is possible and might play an important role for minimal invasive cochlear implantation in the futur