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

This experimental study compares the precision and surgical outcomes of manual versus robotic electrode insertions in cochlear implantation. Conducted on formalin-fixed cadaveric heads, the study involved nine senior neurotologists performing both manual and robotic insertions. The results showed no statistically significant difference between the two methods in insertion angle, cochlear coverage, or electrode coverage. However, the robotic method demonstrated a significantly slower and more controlled insertion speed (0.1 mm/s) than manual insertion (0.66 ± 0.31 mm/s), crucial for minimizing intra-cochlear force and pressures. While robotic insertions had fewer complications, such as tip fold-over or scala deviation, there were instances of incomplete insertion. The robotic system provided a consistent and controlled insertion process, potentially standardizing cochlear implant surgeries and mitigating 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 surgeries.