Feasibility of Pediatric Robotic Cochlear Implantation in Phantoms

Objective: To demonstrate the feasibility of robotic cochlear implant surgery in subject specific pediatric phantoms. Study design: Pilot study. Materials and Methods: Computed tomographic preoperative encrypted data of ten pediatric subjects (total of 20 sides) between eight months and forty-eight months old, who underwent cochlear implant surgery were studied. Four datasets (n=8 sides) were selected for investigation of the complete robotic procedure including middle and inner ear access and electrode insertion. Results: The planning of the safe trajectory for the robotic approach was possible in 17 of the cases. In 3 sides, planning the trajectory was not possible due to the small size of the facial recess. Bone thickness study demonstrated average sufficient bone thickness at the site of screw implantation in general. The complete robotic procure including the drilling and insertion was successfully carried out on all the created phantoms. Conclusion: With this work we have demonstrated the feasibility of planning and performing a robotic middle and inner ear access and cochlear implantation in phantom models of pediatric subjects. To develop and validate the proposed procedure for use in children, next stage optimization of the current surgical workflow and adaptation of the surgical material to pediatric population is necessary.