Panel presentation of Imaging in CI

cochlear implantation approach in pediatric otolaryngolgy subspecialty is discussed

Introduction: Cochlear implantation has evolved toward atraumatic "soft surgery" techniques aimed at preserving intracochlear structures and residual hearing. Manual electrode insertion, while effective, is subject to human tremor and variable insertion speeds, which may increase the risk of scalar translocation or mechanical trauma. Robotic-assisted insertion offers a specialized solution by providing stabilized, slow, and robotic electrode advancement designed to minimize intracochlear pressure transients and mechanical trauma.

Methods/Surgical Technique: This "Masters in Surgery" video presentation focuses specifically on the integration and deployment of the IotaMotion robotic system following the completion of the surgical approach. The video highlights the specialized technical maneuvers required for robotic assistance, including:

• System Calibration and Docking: The precise alignment of the robotic drive with the cochleostomy or round window.

• Electrode Loading: The methodology for securing the electrode array within the robotic carrier.

• Robotic Insertion: The execution of a constant-velocity, low-force insertion, demonstrating the surgeon’s ability to pause and adjust in real-time.

• Disengagement: The safe removal of the robotic drive while maintaining the final electrode position.

Results/Discussion: Outcomes of this presentation will be to provide a detailed demonstration that the audience may apply to their practice, with high-quality operative video that highlights the transition from manual tactile feedback to robotic precision. The presentation will also generate discussion among experts regarding soft surgical techniques and the potential for improved hearing preservation outcomes through the reduction of intracochlear trauma.

Conclusion: This video serves as a technical guide for neurotologists to refine their cochlear implant insertion technique, focusing on the interface between robotic precision and microsurgical control to optimize patient outcomes.

“We present a rare case of far-advanced otosclerosis resulting in profound sensorineural hearing loss, managed successfully with cochlear implantation, highlighting the unique preoperative and intraoperative considerations.”