Feasibility of Robotic Multiport Cochlear Implantation – Evaluation in an Ex-Vivo Model

Objective: Robotic cochlear implantation requires visualization and potentially manipulative assistance during the electrode-array insertion process. This study investigates the feasibility of cochlear implant electrode-array insertion through three robotically drilled middle ear access tunnels. Methods: Three tunnels targeting the round window were planned and drilled in four human cadaveric ear specimens using a surgical robotic system. Two tunnels passed through the facial recess, whereas one tunnel was planned su-prameatal. The electrode-array was inserted into the cochlea on four heads through the superior facial recess tunnel. Endoscopic visualization of the insertion process was provided through the inferior facial recess tunnel. Manipula-tive assistance was provided through the suprameatal tunnel. Results: All tunnels could successfully be planned and drilled. Successful insertion was achieved in all specimens in under 15 minutes. Conclusions: Electrode-array insertion with a multi-port approach is feasible.