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. Where the width of the facial recess is less than 2.5 mm, the chorda tympani nerve and the ossicles are at risk.

Spline curve reconstructions appear to be the best option for anatomical diagnostics in clinical practice. Retrospective studies can be performed to further evaluate model-based evaluations.

Conclusions We have demonstrated that an automated insertion tool (a.k.a. robot) can be used to duplicate a complex surgical motion in inserting cochlear implant electrode arrays via the “advance-off-stylet” technique (AOS). As compared to human operators, the forces generated by the robot were slightly larger but the robot was more reliable (i.e. less force maxima). Objectives We present force data collected during cochlear implant electrode insertion by human operators and by an automated insertion tool (a.k.a. robot). Methods Using a three-dimensional, anatomically-correct, translucent model of the scala tympani chamber of the cochlea, cochlear implant electrodes were inserted either by one of three surgeons (26 insertions) or by the robotic insertion tool (8 insertions). Force was recorded using a load beam cell calibrated for expected forces of less than 0.1 Newtons. The insertions were also videotaped to allow correlation of force with depth of penetration into the cochlea and speed of insertion. Results Average insertion force by the surgeons was 0.004±0.001N and for the insertion tool 0.005±0.014N (p < 0.00001, Student’s t-test). While the average insertion force of the automated tool was larger than that of the surgeons, the surgeons did have intermittent peaks during the AOS component of the insertion (between 120° and 200°).

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