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De Seta D, Daoudi H, Torres R, et al. Robotics, automation, active electrode arrays, and new devices for cochlear implantation: A contemporary review. Hear Res. 2021;414:108425doi: 10.1016/j.heares.2021.108425.
De Seta, D., Daoudi, H., Torres, R., Ferrary, E., Sterkers, O., & Nguyen, Y. (2022). Robotics, automation, active electrode arrays, and new devices for cochlear implantation: A contemporary review. Hearing research, 414108425. https://doi.org/10.1016/j.heares.2021.108425
De Seta, Daniele, et al. "Robotics, automation, active electrode arrays, and new devices for cochlear implantation: A contemporary review." Hearing research vol. 414 (2022): 108425. doi: https://doi.org/10.1016/j.heares.2021.108425
De Seta D, Daoudi H, Torres R, Ferrary E, Sterkers O, Nguyen Y. Robotics, automation, active electrode arrays, and new devices for cochlear implantation: A contemporary review. Hear Res. 2022 Feb;414:108425. doi: 10.1016/j.heares.2021.108425. Epub 2021 Dec 25. PMID: 34979455.
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Hear Res. 2022 Feb;414:108425. doi: 10.1016/j.heares.2021.108425. Epub 2021 Dec 25.

Robotics, automation, active electrode arrays, and new devices for cochlear implantation: A contemporary review.

Hearing research

Daniele De Seta, Hannah Daoudi, Renato Torres, Evelyne Ferrary, Olivier Sterkers, Yann Nguyen

Affiliations

  1. Inserm/Institut Pasteur, Institut de l'Audition, Technologie et Thérapie Génique de la Surdité, Paris, France; San Giovanni-Addolorata Hospital, Unit of Otolaryngology, Rome, Italy. Electronic address: [email protected].
  2. Inserm/Institut Pasteur, Institut de l'Audition, Technologie et Thérapie Génique de la Surdité, Paris, France; Sorbonne Université/AP-HP, GHU Pitié-Salpêtrière, DMU ChIR, Service ORL, GRC Robotique et Innovation Chirurgicale, Paris, France.
  3. Inserm/Institut Pasteur, Institut de l'Audition, Technologie et Thérapie Génique de la Surdité, Paris, France; Sorbonne Université/AP-HP, GHU Pitié-Salpêtrière, DMU ChIR, Service ORL, GRC Robotique et Innovation Chirurgicale, Paris, France; Universidad Nacional de San Agustin de Arequipa, Facultad de Medicina, Departamento de Ciencias Fisiologicas, Av. Alcides Carrión 04000, Arequipa, Peru.
  4. Inserm/Institut Pasteur, Institut de l'Audition, Technologie et Thérapie Génique de la Surdité, Paris, France.
  5. Inserm/Institut Pasteur, Institut de l'Audition, Technologie et Thérapie Génique de la Surdité, Paris, France; San Giovanni-Addolorata Hospital, Unit of Otolaryngology, Rome, Italy.

PMID: 34979455 DOI: 10.1016/j.heares.2021.108425

Abstract

In the last two decades, cochlear implant surgery has evolved into a minimally invasive, hearing preservation surgical technique. The devices used during surgery have benefited from technological advances that have allowed modification and possible improvement of the surgical technique. Robotics has recently gained popularity in otology as an effective tool to overcome the surgeon's limitations such as tremor, drift and accurate force control feedback in laboratory testing. Cochlear implantation benefits from robotic assistance in several steps during the surgical procedure: (i) during the approach to the middle ear by automated mastoidectomy and posterior tympanotomy or through a tunnel from the postauricular skin to the middle ear (i.e. direct cochlear access); (ii) a minimally invasive cochleostomy by a robot-assisted drilling tool; (iii) alignment of the correct insertion axis on the basal cochlear turn; (iv) insertion of the electrode array with a motorized insertion tool. In recent years, the development of bone-attached parallel robots and image-guided surgical robotic systems has allowed the first successful cochlear implantation procedures in patients via a single hole drilled tunnel. Several other robotic systems, new materials, sensing technologies applied to the electrodes, and smart devices have been developed, tested in experimental models and finally some have been used in patients with the aim of reducing trauma in cochleostomy, and permitting slow and more accurate insertion of the electrodes. Despite the promising results in laboratory tests in terms of minimal invasiveness, reduced trauma and better hearing preservation, so far, no clinical benefits on residual hearing preservation or better speech performance have been demonstrated. Before these devices can become the standard approach for cochlear implantation, several points still need to be addressed, primarily cost and duration of the procedure. One can hope that improvement in the cost/benefit ratio will expand the technology to every cochlear implantation procedure. Laboratory research and clinical studies on patients should continue with the aim of making intracochlear implant insertion an atraumatic and reversible gesture for total preservation of the inner ear structure and physiology.

Copyright © 2021. Published by Elsevier B.V.

Keywords: Cochlear implant; Image-guided procedure; Insertion tool; Minimally invasive; Neuronavigation; Robotics

Conflict of interest statement

Declaration of Competing Interest All of the Authors work for or collaborate with the laboratory where the RobOtol® system has been designed and developed. OS and YN are currently consultant and scien

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