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
Evaluation of manual and robot-assisted electrode placement in malformed cochleae using imaging-based patient specific 3D models.
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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Abstract
purposeCochlear implantation in congenital inner ear malformations can be technically challenging due to the atypical anatomy which can limit electrode selection, trajectory, and insertion depth. Although high-resolution CT/MRI and planning tools (e.g., OTOPLAN
methodsHigh-resolution CT and/or MRI from 8 paediatric candidates were used to reconstruct and 3D print 16 cochleae (malformed cochleae plus one anatomically normal control with eighth nerve aplasia, as applicable). Four electrode arrays (MED-EL Medium, MED-EL Compressed, MED-EL Flex24, and Cochlear Straight) were inserted by an expert surgeon (P1), a novice surgeon (P2), and a robotic system (RobOtol
resultsElectrode type and cochlear anatomy were the primary determinants of insertion outcomes. Electrode arrays with shorter active lengths (MED-EL Compressed) demonstrated higher insertion completeness in anatomically restricted malformed cochleae, whereas Flex24 and Cochlear Straight showed reduced completeness in restrictive hypoplastic cochleae. Operator identity, including robotic assistance, had minimal impact; ease was generally high. OTOPLAN
conclusionIn malformed cochleae, insertion completeness was influenced primarily by cochlear morphology and electrode characteristics within the outcome measures assessed. Patient-specific 3D models provide a useful platform for electrode-anatomy compatibility assessment and preoperative planning; however, clinical validation incorporating tonotopic coverage, audiological outcomes, and objective robotic performance metrics is warranted.
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