Clin Exp Otorhinolaryngol.  2025 Feb;18(1):21-29. 10.21053/ceo.2024.00253.

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

• Alhabib SF
• Alzhrani F
• Alsanosi A
• Al-Amro M
• Alballaa A
• Shami I
• Hagr A
• Alahmadi A
• Sharif T
• Stichling M
• Matulic M
• Assadi MZ
• Abdelsamad Y
• Almuhawas F

• KMID: 2565230
• DOI: http://doi.org/10.21053/ceo.2024.00253

Abstract

Objectives
. This experimental study compared the precision and surgical outcomes of manual versus robotic electrode insertions in cochlear implantation.
Methods
. The study was conducted on formalin-fixed cadaveric heads, with nine senior neurotologists performing both manual and robotic insertions.
Results
. The results showed no statistically significant differences between the two methods in terms of insertion angle, cochlear 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 minimizing 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 significant advantages in controlling insertion speed and consistency, supporting the continued development and clinical evaluation of robotic systems for cochlear implant surgery.

Keyword

Cochlear Implantation; Robotic Insertion; Manual Insertion; Robotic Cochlear Implantation; Electrode Coverage