Cochlear implantation has a recognised therapeutic role in children with severe to profound hearing loss. The surgery requires expertise in learning the technical skill together with adaptation to variation in anatomy. There is growing interest in healthcare to integrate robotic technology into the surgical field. Robotic assistance should, in principle, remove tremor and reduce or smooth movement speed of electrode placement to theoretically optimise hearing results and minimise risk of damage to surrounding structures. The authors carried out a retrospective study of a single operator’s work with 10 implants inserted manually and 10 with robotic assistance from 2017 to 2023. Three different implants were used (Advanced Bionics™ /Med-El™ /Oticon™). The robot assistant was the RobOtol® platform. Results appeared comparable to existing literature. Mean pure-tone audiogram results showed 40 +/- 11.5 dB in the manual group and 43.3 +/- 10.4 dB in the assisted group between 6–9 months postoperatively. In addition, they found the installation and use of the robot-assisted surgical equipment did not significantly increase operating time. Manual insertion 124.1 +/- 58.1 min and assisted insertion 138.1 +/- 43.9 min, the mastoidectomy being the longest aspect of the procedure. The main limitations of this study are the small sample size, which ultimately limited statistical power, and the single centre/surgeon. However, it does add to the growing literature indicating safety and feasibility of robot-assisted implantation. A prospective, randomised, single-blind, multicentre study would be desirable in the future.
Robot-assisted paediatric cochlear implantation
Reviewed by Aaron Ferguson
Paediatric Robotic Cochlear Implantation: Hearing Outcomes.
