Evidence map›Paper›PMID 41188631›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026

Robotic keyhole access to the semicircular canals for vestibular implantation: an anatomical feasibility study.

Philipp Aebischer, Tom Gawliczek, Elke Loos, Franca Wagner, Stefan Weder, Marco Caversaccio, Nils Guinand, Raymond van de Berg, Georgios Mantokoudis

Abstract readClinical Study
PubMed Full text at PMC Publisher
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Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

9 authors.

Philipp AebischerHearing Research Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Murtenstrasse 50, 3008, Bern, Switzerland. philipp.aebischer@unibe.ch.ORCID http://orcid.org/0000-0001-5661-9847
Tom GawliczekDepartment of Otorhinolaryngology, Head and Neck Surgery, Inselspital University Hospital, Bern, Switzerland.
Elke LoosDepartment of Otorhinolaryngology-Head and Neck Surgery, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University Medical Center, Maastricht, Netherlands.
Franca WagnerDepartment of Otorhinolaryngology, Head and Neck Surgery, Inselspital University Hospital, Bern, Switzerland.
Stefan WederDepartment of Otorhinolaryngology, Head and Neck Surgery, Inselspital University Hospital, Bern, Switzerland.
Marco CaversaccioHearing Research Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Murtenstrasse 50, 3008, Bern, Switzerland.
Nils GuinandDivision of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.
Raymond van de BergDepartment of Otorhinolaryngology-Head and Neck Surgery, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University Medical Center, Maastricht, Netherlands.
Georgios MantokoudisDepartment of Otorhinolaryngology, Head and Neck Surgery, Inselspital University Hospital, Bern, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVestibular implants are a promising treatment for patients with severe bilateral vestibulopathy. However, precise and minimally invasive access to the semicircular canals remains a key surgical challenge.

objectiveTo evaluate the anatomical feasibility of robotic keyhole access to the three semicircular canals for vestibular implantation using image-guided drilling.

methodsHigh-resolution computed tomography scans from 30 ears were analyzed to simulate drill trajectories to the superior, lateral, and posterior semicircular canals. Trajectories were evaluated for surgical accessibility, safety margins relative to critical structures, and approach angles suitable for electrode insertion. Mutually optimized entry points within a simple cortical mastoidectomy were identified.

resultsSafe access to the three canals was feasible in all cases. The lateral and posterior canals were consistently accessible at favorable semicircular canal entry angles. The superior canal required steeper semicircular canal entry angles but remained within acceptable limits. In all cases, three suitable trajectories could be planned to originate from a single 15 mm retroauricular mastoidectomy region.

conclusionRobotic keyhole access to the semicircular canals is anatomically feasible across a range of patient anatomies. These findings support the clinical potential of minimally invasive, image-guided vestibular implantation.

Indexed as

Otologic Surgical ProceduresProsthesis ImplantationRobotic Surgical ProceduresSemicircular CanalsVestibular DiseasesAdolescentAdultAgedAged, 80 and overFeasibility StudiesFemaleHumansMaleMiddle AgedSurgery, Computer-AssistedTomography, X-Ray ComputedElectrode insertionImage-guided surgeryMinimally invasive surgeryRobotic keyhole accessSemicircular canalTemporal bone anatomyVestibular implant

Identifiers

PMID41188631
PMCPMC12987907

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.