ArticleThe Laryngoscope2026
Robotic-Assisted Electrode Array Insertion Improves Stability of Acoustic Hearing Thresholds.
Article in The Laryngoscope, 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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Abstract
OBJECTIVE(S): Robotic-assisted electrode array (EA) insertion is a promising technique that may enhance preservation of residual acoustic hearing after cochlear implant (CI) surgery. The purpose of this study is to evaluate the impact of robotic-assisted EA insertion on rates of delayed-onset hearing loss (DOHL).
methodsSixty (Advanced Bionics [AB]: 30, MED-EL: 30) adult patients underwent CI surgery with manual EA insertion and 29 (AB: 13, MED-EL: 16) with robotic-assisted insertion using the iotaSOFT system. The primary outcome variable was longitudinal change in low frequency pure-tone average (LFPTA). DOHL was defined as a decrease in LFPTA of > 10 dB compared to previous best postoperative LFPTA.
resultsTwenty-two (37%) out of the 60 subjects in the manual cohort and two (7%) out of the 29 subjects in the robotic-assisted cohort had DOHL over the entire length of available follow-up (p = 0.002, Fisher's exact test, two-tailed). When evaluating DOHL results for subjects who had LFPTA data at 12 months (±4 weeks) post initial activation, 11 (29%) out of the 38 (AB: 15, MED-EL: 23) subjects in the manual cohort and zero (0%) out of the 18 (AB: 8, MED-EL: 10) subjects in the robotic-assisted cohort had DOHL (p = 0.011, Fisher's exact test, two-tailed). The number needed to treat was 4.
conclusionRobotic-assisted EA insertion is associated with a clinically meaningful reduction in rates of DOHL. Preservation of residual acoustic hearing is a critical goal in CI surgery, and robotic-assisted EA insertion contributes towards achieving this goal. LEVEL OF EVIDENCE: 3:
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