TY - JOUR
T1 - Suitable Electrode Choice for Robotic-Assisted Cochlear Implant Surgery
T2 - A Systematic Literature Review of Manual Electrode Insertion Adverse Events
AU - Van de Heyning, Paul
AU - Roland, Peter
AU - Lassaletta, Luis
AU - Agrawal, Sumit
AU - Atlas, Marcus
AU - Baumgartner, Wolf-Dieter
AU - Brown, Kevin
AU - Caversaccio, Marco
AU - Dazert, Stefan
AU - Gstoettner, Wolfgang
AU - Hagen, Rudolf
AU - Hagr, Abdulrahman
AU - Jablonski, Greg Eigner
AU - Kameswaran, Mohan
AU - Kuzovkov, Vladislav
AU - Leinung, Martin
AU - Li, Yongxin
AU - Loth, Andreas
AU - Magele, Astrid
AU - Mlynski, Robert
AU - Mueller, Joachim
AU - Parnes, Lorne
AU - Radeloff, Andreas
AU - Raine, Chris
AU - Rajan, Gunesh
AU - Schmutzhard, Joachim
AU - Skarzynski, Piotr H
AU - Skarzynski, Piotr H
AU - Sprinzl, Georg
AU - Staecker, Hinrich
AU - Stöver, Timo
AU - Tavora-Viera, Dayse
AU - Topsakal, Vedat
AU - Usami, Shin-Ichi
AU - Van Rompaey, Vincent
AU - Weiss, Nora M
AU - Wimmer, Wilhelm
AU - Zernotti, Mario
AU - Gavilan, Javier
N1 - Funding Information:
The authors thank Dr. Anandhan Dhanasingh for editing a version of this document and Dr. Edwin Wappl-Kornherr for his assistance in the statistical analysis. The authors of the paper are members of the HEARRING group. The HEARRING Group is an independent network of world leading centers and experts dealing with all aspects of hearing disorders. We believe that advancements in the field of hearing devices are achieved through international research and the pooling of collective experience. Therefore, HEARRING members are committed to leading research in hearing device science, to advancing audiological procedures, and to developing and perfecting surgical techniques.
Publisher Copyright:
Copyright © 2022 Van de Heyning, Roland, Lassaletta, Agrawal, Atlas, Baumgartner, Brown, Caversaccio, Dazert, Gstoettner, Hagen, Hagr, Jablonski, Kameswaran, Kuzovkov, Leinung, Li, Loth, Magele, Mlynski, Mueller, Parnes, Radeloff, Raine, Rajan, Schmutzhard, Skarzynski, Skarzynski, Sprinzl, Staecker, Stöver, Tavora-Viera, Topsakal, Usami, Van Rompaey, Weiss, Wimmer, Zernotti and Gavilan.
PY - 2022/3/24
Y1 - 2022/3/24
N2 - Background and Objective: The cochlear implant (CI) electrode insertion process is a key step in CI surgery. One of the aims of advances in robotic-assisted CI surgery (RACIS) is to realize better cochlear structure preservation and to precisely control insertion. The aim of this literature review is to gain insight into electrode selection for RACIS by acquiring a thorough knowledge of electrode insertion and related complications from classic CI surgery involving a manual electrode insertion process.Methods: A systematic electronic search of the literature was carried out using PubMed, Scopus, Cochrane, and Web of Science to find relevant literature on electrode tip fold over (ETFO), electrode scalar deviation (ESD), and electrode migration (EM) from both pre-shaped and straight electrode types.Results: A total of 82 studies that include 8,603 ears implanted with a CI, i.e., pre-shaped (4,869) and straight electrodes (3,734), were evaluated. The rate of ETFO (25 studies, 2,335 ears), ESD (39 studies, 3,073 ears), and EM (18 studies, 3,195 ears) was determined. An incidence rate (±95% CI) of 5.38% (4.4-6.6%) of ETFO, 28.6% (26.6-30.6%) of ESD, and 0.53% (0.2-1.1%) of EM is associated with pre-shaped electrodes, whereas with straight electrodes it was 0.51% (0.1-1.3%), 11% (9.2-13.0%), and 3.2% (2.5-3.95%), respectively. The differences between the pre-shaped and straight electrode types are highly significant (p < 0.001). Laboratory experiments show evidence that robotic insertions of electrodes are less traumatic than manual insertions. The influence of round window (RW) vs. cochleostomy (Coch) was not assessed.Conclusion: Considering the current electrode designs available and the reported incidence of insertion complications, the use of straight electrodes in RACIS and conventional CI surgery (and manual insertion) appears to be less traumatic to intracochlear structures compared with pre-shaped electrodes. However, EM of straight electrodes should be anticipated. RACIS has the potential to reduce these complications.
AB - Background and Objective: The cochlear implant (CI) electrode insertion process is a key step in CI surgery. One of the aims of advances in robotic-assisted CI surgery (RACIS) is to realize better cochlear structure preservation and to precisely control insertion. The aim of this literature review is to gain insight into electrode selection for RACIS by acquiring a thorough knowledge of electrode insertion and related complications from classic CI surgery involving a manual electrode insertion process.Methods: A systematic electronic search of the literature was carried out using PubMed, Scopus, Cochrane, and Web of Science to find relevant literature on electrode tip fold over (ETFO), electrode scalar deviation (ESD), and electrode migration (EM) from both pre-shaped and straight electrode types.Results: A total of 82 studies that include 8,603 ears implanted with a CI, i.e., pre-shaped (4,869) and straight electrodes (3,734), were evaluated. The rate of ETFO (25 studies, 2,335 ears), ESD (39 studies, 3,073 ears), and EM (18 studies, 3,195 ears) was determined. An incidence rate (±95% CI) of 5.38% (4.4-6.6%) of ETFO, 28.6% (26.6-30.6%) of ESD, and 0.53% (0.2-1.1%) of EM is associated with pre-shaped electrodes, whereas with straight electrodes it was 0.51% (0.1-1.3%), 11% (9.2-13.0%), and 3.2% (2.5-3.95%), respectively. The differences between the pre-shaped and straight electrode types are highly significant (p < 0.001). Laboratory experiments show evidence that robotic insertions of electrodes are less traumatic than manual insertions. The influence of round window (RW) vs. cochleostomy (Coch) was not assessed.Conclusion: Considering the current electrode designs available and the reported incidence of insertion complications, the use of straight electrodes in RACIS and conventional CI surgery (and manual insertion) appears to be less traumatic to intracochlear structures compared with pre-shaped electrodes. However, EM of straight electrodes should be anticipated. RACIS has the potential to reduce these complications.
KW - electrode migration
KW - pre-shaped electrode
KW - robotic assisted cochlear implant surgery
KW - scalar deviation
KW - straight electrode
KW - tip fold-over
UR - http://www.scopus.com/inward/record.url?scp=85128764341&partnerID=8YFLogxK
U2 - 10.3389/fsurg.2022.823219
DO - 10.3389/fsurg.2022.823219
M3 - Review article
C2 - 35402479
SN - 2296-875X
VL - 9
SP - 823219
JO - Frontiers in Surgery
JF - Frontiers in Surgery
M1 - 823219
ER -