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ORIGINAL RESEARCH article

Front. Surg.

Sec. Otorhinolaryngology - Head and Neck Surgery

Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1700744

Hearing Preservation Outcomes with Motorized Cochlear Implant Electrode Insertion: Matched-Cohort Observations

Provisionally accepted
  • 1University Hospital Bern, Department of Ear, Nose and Throat Diseases, Head and Neck Surgery, Bern, Switzerland
  • 2Universitat Bern ARTORG Center for Biomedical Engineering Research, Bern, Switzerland

The final, formatted version of the article will be published soon.

Background: Cochlear implants (CIs) are an established treatment for severe sensorineural hearing loss and are increasingly used in patients with substantial residual hearing. Preservation of residual hearing is associated with improved outcomes, including speech understanding in noise, natural sound perception, and spatial hearing. Manual electrode insertion, however, is limited by hand tremor and abrupt maneuvers, which can cause intracochlear trauma. Motorized insertion tools (MITs) have been developed to enable slow, continuous, and highly controlled electrode advancement. Methods: We conducted the first clinical evaluation of the OTOARM/OTODRIVE MIT system. Twenty-six patients underwent implantation with lateral wall electrodes using MIT and were compared with a matched retrospective cohort who received manual insertion. Surgical workflow integration, electrode positioning, residual hearing, speech comprehension, and patient-reported outcome measures (PROMs) were assessed at 1 and 6 months postoperatively. Results: MIT integration into the surgical routine was feasible without major workflow disruptions. Angular insertion depth and electrode positioning did not differ significantly between groups. Patients with favorable preoperative hearing showed slightly better postoperative low-frequency pure tone thresholds in the MIT group, although statistical significance was not reached. Speech comprehension outcomes were comparable between groups. PROMs indicated greater gains in several subscales for the MIT-assisted cohort, despite incomplete data and limited statistical power. Conclusion: MIT-assisted cochlear implantation was feasible and demonstrated a tendency toward improved hearing preservation and subjective benefit. However, the small sample size, retrospective controls, and incomplete PROM data limit definitive conclusions. Larger, blinded and randomized trials are needed to determine the clinical value of MIT systems for both objective and patient-reported outcomes.

Keywords: Cochlear Implantation, Hearing preservation, Motorized insertion tool (MIT), Robotic-assisted surgery, Speechcomprehension, Patient-reported outcome measures (PROMs)

Received: 07 Sep 2025; Accepted: 20 Oct 2025.

Copyright: © 2025 Oetiker, Aebischer, Caversaccio, Mantokoudis and Weder. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Stefan Weder, stefan.weder@insel.ch

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