Robotics for Cochlear Implantation Surgery: Challenges and Opportunities

  title={Robotics for Cochlear Implantation Surgery: Challenges and Opportunities},
  author={Kush Panara and David Shahal and Rahul Mittal and Adrien A. Eshraghi},
  journal={Otology \& Neurotology},
  pages={e825 - e835}
Supplemental Digital Content is available in the text Objectives: Recent advancements in robotics have set forth a growing body of evidence for the clinical application of the robotic cochlear implantation (RCI), with many potential benefits. This review aims to summarize these efforts, provide the latest developments in this exciting field, and explore the challenges associated with the clinical implementation of RCI. Data Sources: MEDLINE, PubMed, and EMBASE databases. Study Selection: A… 
1 Citations
Robotic Cochlear Implant Surgery: Imaging-Based Evaluation of Feasibility in Clinical Routine
Up to two thirds of ears were eligible for robotic cochlear implant surgery with the standard drill bit size of 1.8 mm, but the main reason for inability to plan the keyhole access was insufficient image resolution causing anatomical landmarks not being accurately identified.


Robotic cochlear implantation: surgical procedure and first clinical experience
Abstract Conclusion: A system for robotic cochlear implantation (rCI) has been developed and a corresponding surgical workflow has been described. The clinical feasibility was demonstrated through
Robotic middle ear access for cochlear implantation: First in man
To demonstrate the feasibility of robotic middle ear access in a clinical setting, nine adult patients with severe-to-profound hearing loss indicated for cochlear implantation were included in this clinical trial and robotically drilled to the level of the facial recess.
Instrument flight to the inner ear
The results demonstrate the feasibility and possibilities of using robotic technology for microsurgery on the lateral skull base and has the potential for benefit in other microsurgical domains for which there is no task-oriented robotic technology available at present.
A new manual insertion tool for minimally invasive, image-guided cochlear implant surgery
The first cadaver experiments using a new manual insertion tool which provides a roller mechanism to enable the physician to deploy a cochlear implant electrode array through the narrow drilled hole created by this minimally invasive, image-guided access technique are described.
Feasibility of Pediatric Robotic Cochlear Implantation in Phantoms.
The feasibility of planning and performing a robotic middle and inner ear access and cochlear implantation in phantom models of pediatric subjects is demonstrated and the proposed procedure for use in children is validated.
In Vitro Accuracy Evaluation of Image-Guided Robot System for Direct Cochlear Access
  • B. Bell, N. Gerber, S. Weber
  • Medicine
    Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • 2013
Improvements made to an image-guided surgical robot system developed specifically for this purpose are reported and the resulting accuracy achieved in vitro is mimics the envisioned clinical procedure showing the feasibility of future clinical implementation.
A robot-guided minimally invasive approach for cochlear implant surgery: preliminary results of a temporal bone study
This preliminary study suggests that robot-guided drilling of a minimally invasive approach to the cochlea might be feasible, but further improvements are necessary before any clinical application becomes possible.
A Neuromonitoring Approach to Facial Nerve Preservation During Image-guided Robotic Cochlear Implantation
  • J. Ansó, C. Dür, S. Weber
  • Medicine
    Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • 2016
It is suggested that although no general correlation between facial nerve distance and stimulation threshold existed, correlations at very close distances to the facial nerve and high levels of specificity would enable a binary response warning system to be developed using the proposed probe at low stimulation currents.
Systematic review: Radiological and histological evidence of cochlear implant insertion trauma in adult patients
Minimizing cochlear trauma during implant insertion is important to preserve residual hearing and optimize audiological performance, and an overall 17.6% trauma rate suggests that CI insertion could be improved with more accurate and consistent electrode insertion such as in the form of robotic guidance.
An automated insertion tool for cochlear implants: another step towards atraumatic cochlear implant surgery
The automated insertion tool has proven its capability to perform electrode insertions with final insertion depth angles within the target range of a standard cochlear implant surgery.