{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T12:09:51Z","timestamp":1793362191962,"version":"4.5.0"},"reference-count":33,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["NIH NIDCD P50\u2010DC000242"],"award-info":[{"award-number":["NIH NIDCD P50\u2010DC000242"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["NIH NIDCD T32\u2010DC000040\u201029"],"award-info":[{"award-number":["NIH NIDCD T32\u2010DC000040\u201029"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective(s)<\/jats:title>\n                    <jats:p>Robotic\u2010assisted electrode array (EA) insertion is a promising technique that may enhance hearing preservation in cochlear implant (CI) surgery. The purpose of our study is to understand the extent to which robotic\u2010assisted EA insertion improves hearing preservation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty\u2010four adult patients underwent CI surgery with manual EA insertion and 27 adult patients underwent CI surgery with robotic\u2010assisted EA insertion using the iotaSOFT system. The EAs used included the Flex 20\/24\/26. The primary outcome variable was low frequency pure\u2010tone average (LFPTA), defined as mean audiometric threshold at 125, 250, and 500\u2009Hz. This was measured preoperatively, at initial activation (within 4\u2009weeks of surgery), and subsequently at 2\u2009weeks, 3\u2009months, 6\u2009months, and 1\u2009year. Functional acoustic hearing was defined as LFPTA &lt;\u200980\u2009dB HL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventeen out of 24 patients (71%) in the manual insertion group and 23 out of 27 patients (85%) in the robotic\u2010assisted EA insertion group had preserved functional acoustic hearing (&lt;\u200980\u2009dB HL) up till 1\u2009year (Fisher's exact test (two\u2010tailed) is not statistically significant,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.31). The number needed to treat with robotic\u2010assisted EA insertion to prevent one additional negative outcome of loss of functional acoustic hearing would be 7 (1\/0.14).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Robotic\u2010assisted EA insertion is associated with improved hearing preservation over 1\u2009year compared with manual insertion. Hearing preservation leads to improved outcomes and therefore every effort should be made to preserve the delicate structure and function of the cochlea during EA insertion. Robotic\u2010assisted EA insertion advances that objective.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Level of Evidence:<\/jats:bold>\n                      III (cohort study).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.32318","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T08:29:35Z","timestamp":1749630575000},"page":"4364-4371","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Robotic\u2010Assisted Electrode Array Insertion Improves Rates of Hearing Preservation"],"prefix":"10.1002","volume":"135","author":[{"given":"Uzair A.","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Iowa Health Care  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7839-2073","authenticated-orcid":false,"given":"Camille C.","family":"Dunn","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Iowa Health Care  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0285-526X","authenticated-orcid":false,"given":"Rachel A.","family":"Scheperle","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Iowa Health Care  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Oleson","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Iowa  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3056-5646","authenticated-orcid":false,"given":"Alexander D.","family":"Claussen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Iowa Health Care  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce J.","family":"Gantz","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Iowa Health Care  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6884-4897","authenticated-orcid":false,"given":"Marlan R.","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Iowa Health Care  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2022.108487"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0232421"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002189"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/14670100.2021.1898111"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000262604"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3766\/jaaa.21.1.6"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/14992027.2013.802032"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0b013e31827e8163"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLG.0000157695.07536.D2"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000095608"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2017.04.005"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10162\u2010021\u201000809\u2010z"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000000742"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1335994"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000342821"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002164"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002596"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003749"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25572"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1159\/000206493"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25451"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000004094"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002083"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002608"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003707"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1159\/000540577"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010024\u201009195\u20107"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818764329"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1044\/2024_AJA\u201024\u201000008"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001110"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2024.104360"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2021.108425"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11237045"}],"container-title":["The 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