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

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.