Robotic assisted cochlear implantation: Evaluation of the first clinical experience with HEARO​ in Germany

Introduction Robotic assistance systems are able to surpass the surgeon’s precision in standardized surgical steps. The HEARO system, a drilling robot for the lateral skull base is the first commercial system capable of autonomously drilling from the skull surface to the round window with sufficiently high accuracy (Caversaccio et al. 2019). Our work focuses on the evaluation of the first HEARO robotic assisted CI implantation in Germany.

Methods The basis of our work is the analysis of the clinical data of the first two patients including the pre- and intraoperative imaging. The planning of the drill channel, the calculation of the distances to critical structures, such as the facial nerve, and the verification of the accuracy is done using the OTOPLAN​ software.

Results In both cases, complete insertion of the electrode over the drilled canal was achieved. The insertion angle was 610 and 522°, respectively. The facial recess showed a width of 3.3, resp. 2.8 mm in the screening, with a minimum distance of 0.45, resp. 0.5 mm between the facial nerve (FN) and the planned trajectory. The distance to the chorda tympani (Ct) was 0.33 and 0.32 mm. Intraoperatively safety of the drilling trajectory was evaluated. Upon the completion of the robotic middle and inner ear access the electrode was successfully inserted through the drilled tunnel. Both procedures were performed without complications.

Conclusion The HEARO system was able to provide a minimally invasive access to the round window with high precision, through which a successful electrode insertion was possible.

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Artikel online veröffentlicht:
12. Mai 2023