Entirely robotic cochlear implant surgery

Introduction: Robot-assisted cochlear implant surgery (RACIS) as defined by the HEARO®-procedure performs minimal invasive cochlear implant (CI) surgery by directly drilling a keyhole trajectory towards the inner ear. Hitherto, an entirely robotic automation including electrode insertion has not been described yet. The feasability of using a newly developed, dedicated motorised device for automated electrode insertion in the first clinical case of entirely robotic cochlear implant surgery was investigated. Aim: The aim is to report the first experience of entirely robotic cochlear implantation surgery. Intervention: RACIS with a straight flexible lateral wall electrode. Primary outcome measurements: Electrode cochlear insertion depth. Secondary outcome measurements: The audiological outcome in terms of mean hearing thresholds. Conclusion: Here, we report on a cochlear implant robot that performs the most complex surgical steps to place a cochlear implant array successfully in the inner ear and render similar audiological results as in conventional surgery. Robots can execute tasks beyond human dexterity and will probably pave the way to standardize residual hearing preservation and broadening the indication for electric-acoustic stimulation in the same ear with hybrid implants.