{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T14:08:44Z","timestamp":1789049324589,"version":"build-2803163510"},"reference-count":20,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Importance:<\/jats:title>\n                    <jats:p>Manual cochlear implant (CI) electrode insertion remains surgeon-dependent and may contribute to intracochlear trauma. Robotic-assisted systems, such as the new Otoarm-Otodrive, offer motorized control at ultra-slow speeds that aim to minimize force fluctuations and pressure changes, potentially improving hearing preservation and surgical consistency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To describe the institutional experience, surgical workflow integration, and feasibility of robot-assisted cochlear implantation (CI) using the Otoarm-Otodrive system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective descriptive study of 50 consecutive robot-assisted CI cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Tertiary referral otology center in Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>Fifty Adult patients undergoing cochlear implantation without cochlear malformation or ossification using a MED-EL device from January to October 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention:<\/jats:title>\n                    <jats:p>Robot-assisted cochlear electrode array insertion using the Otoarm-Otodrive (MED-EL) system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures:<\/jats:title>\n                    <jats:p>Feasibility (setup and insertion times), insertion depth, intraoperative challenges, and integration into operative workflow.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The additional time for robot setup and alignment averaged 374\u2009seconds. Mean electrode insertion duration, performed at a standardized rate of 0.1\u2009mm\/second, was 444\u2009seconds. Postoperative Otoplan analysis in 30 cases demonstrated a mean angular insertion depth of 575\u00b0. No major complications such as facial nerve palsy or infections, and no device-related complications occurred. All but 1 case achieved full insertion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Robot-assisted cochlear electrode insertion using the Otoarm-Otodrive system is safe, reproducible, and easily integrated into standard CI workflow.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance:<\/jats:title>\n                    <jats:p>This first North American experience in using the Otoarm-Otodrive system demonstrates the feasibility of robotic cochlear implant insertion as a step toward achieving atraumatic implantation. Future studies will assess hearing preservation benefits and cost-effectiveness for broader adoption.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19160216261460457","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:18:53Z","timestamp":1788869933000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Clinical Experience With Robot-Assisted Electrode Insertion in Cochlear Implantation Using the Otoarm-Otodrive System"],"prefix":"10.1177","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9960-6883","authenticated-orcid":false,"given":"Kevin Jer V.","family":"David","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent Y. W.","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada"},{"name":"Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada"},{"name":"Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Spiegel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy H.","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari L.","family":"Smilsky","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trung N.","family":"Le","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada"},{"name":"Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1159\/000342821"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2016.11.002"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817704391"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joto.2019.01.002"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2021.3088232"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1515\/cdbme-2019-0111"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e318219f6ac"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.21053\/ceo.2024.00253"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003749"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1159\/000513509"},{"key":"e_1_3_3_12_2","article-title":"The RobOtol system in clinical applications \u2013 our first clinical experience with the robot-assisted insertion of CI electrodes with simultaneous cochlear monitoring","volume":"101","author":"Salcher R","year":"2022","unstructured":"Salcher R, Timm M, Prenzler N, Willenborg K, Haumann S, Lenarz T. The RobOtol system in clinical applications \u2013 our first clinical experience with the robot-assisted insertion of CI electrodes with simultaneous cochlear monitoring. Laryngo-Rhino-Otol. 2022;101:S243-S244.","journal-title":"Laryngo-Rhino-Otol"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003707"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002164"},{"issue":"1","key":"e_1_3_3_15_2","first-page":"80","article-title":"Impedance and functional outcomes in robotic-assisted or manual cochlear implantation: a comparative study","volume":"30","author":"Gersdorff G","year":"2024","unstructured":"Gersdorff G, Peigneux N, Duran U, Camby S, Lefebvre PP. Impedance and functional outcomes in robotic-assisted or manual cochlear implantation: a comparative study. 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