Hearing and Structure Preservation Cochlear Implant Surgery: Precision Techniques and Outcome Optimization

Cochlear implantation (CI) is the state-of-the-art rehabilitation intervention for individuals with severe-to-profound sensorineural hearing loss. Beyond restoring audibility, contemporary CI surgery is increasingly focused on hearing and structure preservation (HSP), aiming to minimize intracochlear trauma and maintain residual function, while preserving the full therapeutic landscape for future regenerative interventions. Recent studies highlight key surgical variables influencing electrode placement accuracy, insertion depth, and functional outcomes, reinforcing the need for refined atraumatic techniques. Advances in intraoperative monitoring and imaging guidance are transforming the field, providing real-time assessment of electrode trajectory and cochlear integrity. However, optimizing the balance between full cochlear coverage and preservation of cochlear health remains an unresolved challenge.

This Research Topic aims to present current evidence and emerging innovations in atraumatic cochlear implant surgery, focusing on strategies that enhance surgical precision and minimize inner-ear trauma. It provides a platform for interdisciplinary exchange among otologists, audiologists, and biomedical engineers to refine best practices. Key objectives include exploring the role of intraoperative monitoring, image-guided frameworks, robotic systems, and electrode design in improving short- and long-term auditory outcomes. In addition, the collection seeks to identify clinical predictors of hearing preservation and to evaluate methods for optimizing electrode insertion and cochlear function.

To further advance the optimization of surgical techniques and patient outcomes, we welcome submissions addressing, but not limited to, the following areas:

o Cochlear implant planning;
o Neurophysiological aspects of cochlear implantation;
o Assessment of cochlear health;
o Early activation;
o Image-guided and robotic-assisted cochlear implant insertion;
o Intraoperative monitoring for atraumatic electrode placement;
o Surgical and anatomical factors influencing hearing preservation;
o Electrode design to minimize cochlear trauma;
o Anatomy Based Fitting;
o Combining HSP and Single-Sided Deafness;
o Long-term outcomes and biomarkers of postoperative cochlear health;
o Translational approaches linking surgical precision to auditory outcomes;
o Comparative analyses of surgical strategies and postoperative rehabilitation.

We accept various article types, including, but not limited to, Original Research, Review, Mini-Review, Clinical Trial, Perspective, and Case Report manuscripts. Case studies are welcome where the case serves as a vehicle to explore, challenge, or underpin a broader clinical concept or surgical principle.

Prof. Javier Gavilán reports consulting relationships with MED-EL.

Prof. Van de Heyning reports consulting relationship with MED-EL, and unrestricted research grants to the institution (Antwerp University Hospital) from MED-EL and Cochlear.

Prof. Hagr reports consulting relationship with MED-EL, and research grants to the King Abdullah ear specialist center from MED-EL, Advanced Bionics and Cochlear.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Curriculum, Instruction, and Pedagogy
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Curriculum, Instruction, and Pedagogy
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Policy and Practice Reviews
• Review
• Study Protocol
• Systematic Review
• Technology and Code

Keywords: Atraumatic Cochlear Implantation, Hearing Preservation, Electrode Insertion, Surgical Precision, Image-Guided Surgery, Intraoperative Monitoring, Robotic-Assisted Surgery, Cochlear Trauma, Electrode Design, Functional Hearing Outcomes

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.