Minimally invasive fully ROBOT‐assisted cochlear implantation in humans: Preliminary results in five consecutive patients

Klopp-Dutote, Nathalie; Lefranc, Michel; Strunski, V.; Page, C.

doi:10.1111/coa.13840

Cited by 11 publications

(9 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Robotic systems, such as HEARO®, Rosa®, which drill a narrow tunnel (direct cochlear access) from the cortex to the cochlea, need an alternate solution for stabilizing the electrode. EM has not been reported in the limited series of patients operated on who have had robotic insertions ( 12 – 15 , 17 , 18 ). Although the narrow tunnel approach itself provides some stabilization and the absence of coiled excess electrode lead in the mastoid cavity minimizes the EMs, caution is needed in fixing the electrode in the tunnel, which might be accomplished, for example with bone paté.…”

Section: Discussionmentioning

confidence: 97%

“…It includes an automated insertion tool for the electrode ( 16 ). Recent reports in a series of patients demonstrate the clinical feasibility and effectiveness of these robotic systems in accommodating various CI electrode variants ( 14 , 15 , 17 , 18 ).…”

Section: Introductionmentioning

confidence: 99%

“…The HEARO® system received a CE mark in the year 2020. A new robotic system called Rosa®, another French innovation that offers robotic-controlled drilling of the mastoid and electrode insertion, has been recently evaluated for safety and accuracy in live patients ( 15 ). RoboJig is a German innovation currently under development.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Suitable Electrode Choice for Robotic-Assisted Cochlear Implant Surgery: A Systematic Literature Review of Manual Electrode Insertion Adverse Events

et al. 2022

View full text Add to dashboard Cite

Background and ObjectiveThe cochlear implant (CI) electrode insertion process is a key step in CI surgery. One of the aims of advances in robotic-assisted CI surgery (RACIS) is to realize better cochlear structure preservation and to precisely control insertion. The aim of this literature review is to gain insight into electrode selection for RACIS by acquiring a thorough knowledge of electrode insertion and related complications from classic CI surgery involving a manual electrode insertion process.MethodsA systematic electronic search of the literature was carried out using PubMed, Scopus, Cochrane, and Web of Science to find relevant literature on electrode tip fold over (ETFO), electrode scalar deviation (ESD), and electrode migration (EM) from both pre-shaped and straight electrode types.ResultsA total of 82 studies that include 8,603 ears implanted with a CI, i.e., pre-shaped (4,869) and straight electrodes (3,734), were evaluated. The rate of ETFO (25 studies, 2,335 ears), ESD (39 studies, 3,073 ears), and EM (18 studies, 3,195 ears) was determined. An incidence rate (±95% CI) of 5.38% (4.4–6.6%) of ETFO, 28.6% (26.6–30.6%) of ESD, and 0.53% (0.2–1.1%) of EM is associated with pre-shaped electrodes, whereas with straight electrodes it was 0.51% (0.1–1.3%), 11% (9.2–13.0%), and 3.2% (2.5–3.95%), respectively. The differences between the pre-shaped and straight electrode types are highly significant (p < 0.001). Laboratory experiments show evidence that robotic insertions of electrodes are less traumatic than manual insertions. The influence of round window (RW) vs. cochleostomy (Coch) was not assessed.ConclusionConsidering the current electrode designs available and the reported incidence of insertion complications, the use of straight electrodes in RACIS and conventional CI surgery (and manual insertion) appears to be less traumatic to intracochlear structures compared with pre-shaped electrodes. However, EM of straight electrodes should be anticipated. RACIS has the potential to reduce these complications.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Suitable Electrode Choice for Robotic-Assisted Cochlear Implant Surgery: A Systematic Literature Review of Manual Electrode Insertion Adverse Events

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Currently, there are four systems for clinical robotic cochlear implantation available. Three of them, Microtable ® (Vanderbilt), HEARO ® (Bern) and ROSA ® (Amiens), are used for direct cochlear access but the number of cases implanted with these devices is still very limited [ 10 , 23 , 24 , 25 , 26 ]. The fourth system (RobOtol ® ) is not intended for drilling, but for robotic alignment of the electrode array and its insertion into the scala tympani.…”

Section: Discussionmentioning

confidence: 99%

Robot-Assisted Electrode Insertion in Cochlear Implantation Controlled by Intraoperative Electrocochleography—A Pilot Study

Gawęcki

Balcerowiak

Podlawska

et al. 2022

JCM

View full text Add to dashboard Cite

Robotics in otology has been developing in many directions for more than two decades. Current clinical trials focus on more accurate stapes surgery, minimally invasive access to the cochlea and less traumatic insertion of cochlear implant (CI) electrode arrays. In this study we evaluated the use of the RobOtol® (Collin, Bagneux, France) otologic robot to insert CI electrodes into the inner ear with intraoperative ECochG analysis. This prospective, pilot study included two adult patients implanted with Advanced Bionics (Westinghouse PI, CA, USA) cochlear implant, with HiFocus™ Mid-Scala electrode array. The standard surgical approach was used. For both subjects, who had residual hearing in the implanted ear, intraoperative and postoperative ECochG was performed with the AIMTM system. The surgeries were uneventful. A credible ECochG response was obtained after complete electrode insertion in both cases. Preoperative BC thresholds compared to intraoperative estimated ECochG thresholds and 2-day postoperative BC thresholds had similar values at frequencies where all thresholds were measurable. The results of the ECochG performed one month after the surgery showed that in both patients the hearing residues were preserved for the selected frequencies. The RobOtol® surgical robot allows for the correct, safe and gentle insertion of the cochlear implant electrode inside the cochlea. The use of electrocochleography measurements during robotic cochlear implantation offers an additional opportunity to evaluate and modify the electrode array insertion on an ongoing basis, which may contribute to the preservation of residual hearing.

show abstract

“…To date, several systems for robot-assisted cochlear implantation are in development or already available on the market. One such system provides robotic-controlled drilling of the mastoid and electrode insertion and has been recently evaluated in patients 3 . Another device is a patient-specific guiding system for tunnel drilling and electrode insertion 4 .…”

Section: Introductionmentioning

confidence: 99%

Robotic Cochlear Implantation for Direct Cochlear Access

Caversaccio

Mantokoudis

Wagner

et al. 2022

JoVE

View full text Add to dashboard Cite

Robot-assisted systems offer great potential for gentler and more precise cochlear implantation. In this article, we provide a comprehensive overview of the clinical workflow for robotic cochlear implantation using a robotic system specifically developed for a minimally invasive, direct cochlear access. The clinical workflow involves experts from various disciplines and requires training to ensure a smooth and safe procedure. The protocol briefly summarizes the history of robotic cochlear implantation. The clinical sequence is explained in detail, beginning with the assessment of patient eligibility and covering surgical preparation, preoperative planning with the special planning software, drilling of the middle ear access, intraoperative imaging to confirm the trajectory, milling of the inner ear access, insertion of the electrode array, and implant management. The steps that require special attention are discussed. As an example, the postoperative outcome of robotic cochlear implantation in a patient with advanced otosclerosis is presented. Finally, the procedure is discussed in the context of the authors' experience.

show abstract

Minimally invasive fully ROBOT‐assisted cochlear implantation in humans: Preliminary results in five consecutive patients

Cited by 11 publications

References 11 publications

Suitable Electrode Choice for Robotic-Assisted Cochlear Implant Surgery: A Systematic Literature Review of Manual Electrode Insertion Adverse Events

Suitable Electrode Choice for Robotic-Assisted Cochlear Implant Surgery: A Systematic Literature Review of Manual Electrode Insertion Adverse Events

Robot-Assisted Electrode Insertion in Cochlear Implantation Controlled by Intraoperative Electrocochleography—A Pilot Study

Robotic Cochlear Implantation for Direct Cochlear Access

Contact Info

Product

Resources

About