Precision Surgical Robot Advances Cochlear Implantation

Innovative robotic technology and a new surgical procedure could lead to improved hearing outcomes for cochlear implantation patients, according to a new study.

Developed by researchers at the University of Bern and Bern University Hospital, the new robotic cochlear implantation (RCI) technique involves the use of surgical planning software and a robotic drill to create a tunnel approximately 2.5 mm in diameter that can provide access to the cochlea from behind the ear. Due to the size and scale of the robotic procedure, the robot carries out the drilling procedure without the need for direct, manual operation by the surgeon.

The minimally invasive keyhole tunnel runs at a safe distance between the facial nerve and the chorda tympani nerve, so that the electrode wire of the implant can be inserted into the cochlea at the correct preplanned angle. Safe navigation and drilling inside the human ear while avoiding damage to nerves and microscopic structures of the inner ear is accomplished through a combination of interlocking safety components that include computer-assisted planning, stereotactic image guidance, in situ assessment of tissue properties, and multipolar neuro-monitoring. The study was published on March 15, 2017, in Science Robotics.

“This first robotic cochlea implantation is the result of a decade of multidisciplinary research by a team of biomedical engineers, neuroradiologists, neurologists, audiologists, allied health professionals, and surgeons,” said senior author Professor Marco Caversaccio, MD, of Inselspital. “The technology underwent rigorous technical and laboratory testing stages to ensure patient safety that would allow the translation of such complex technology from the lab into the operation room.”

A cochlear implant is an electronic medical device that replaces the function of the damaged inner ear. Unlike hearing aids, which make sounds louder, cochlear implants do the work of damaged parts of the inner ear (cochlea) to provide sound signals to the brain.