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Robotic Versus Manual Electrode Insertion in Cochlear Implant Surgery: An Experimental Study

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Objectives. This experimental study compared the precision and surgical outcomes of manual versus robotic electrode in- sertions in cochlear implantation. Methods. The study was conducted on formalin-fixed cadaveric heads, with nine senior neurotologists performing both man- ual and robotic insertions. Results. The results showed no statistically significant differences between the two methods in terms of insertion angle, co- chlear coverage, or electrode coverage. However, the robotic method demonstrated a significantly slower and more controlled insertion speed (0.1 mm/sec) compared to manual insertion (0.66±0.31 mm/sec), which is crucial for min- imizing intra-cochlear force and pressures. Although robotic insertions resulted in fewer complications such as tip fold- over or scala deviation, there were instances of incomplete insertion. Conclusion. The robotic system provided a consistent and controlled insertion process, potentially standardizing cochlear implant operations and reducing outcome variability. The study concludes that robotic-assisted insertion offers signifi- cant advantages in controlling insertion speed and consistency, supporting the continued development and clinical evaluation of robotic systems for cochlear implant surgery.

Abstract

Objectives. This experimental study compared the precision and surgical outcomes of manual versus robotic electrode in- sertions in cochlear implantation. Methods. The study was conducted on formalin-fixed cadaveric heads, with nine senior neurotologists performing both man- ual and robotic insertions. Results. The results showed no statistically significant differences between the two methods in terms of insertion angle, co- chlear coverage, or electrode coverage. However, the robotic method demonstrated a significantly slower and more controlled insertion speed (0.1 mm/sec) compared to manual insertion (0.66±0.31 mm/sec), which is crucial for min- imizing intra-cochlear force and pressures. Although robotic insertions resulted in fewer complications such as tip fold- over or scala deviation, there were instances of incomplete insertion. Conclusion. The robotic system provided a consistent and controlled insertion process, potentially standardizing cochlear implant operations and reducing outcome variability. The study concludes that robotic-assisted insertion offers signifi- cant advantages in controlling insertion speed and consistency, supporting the continued development and clinical evaluation of robotic systems for cochlear implant surgery.

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