14: Robotic Ear Surgery

Robots have allowed for great advances in safety, efficiency, and cost-saving measures across many fields. Although robotic systems in surgery can offer similar benefits, implementation in healthcare settings is accompanied by stringent legislative and patient safety barriers. There are several types of robotic systems being used, tested, or developed for applications in ear surgery. This chapter discusses three main types of robotic surgical systems: 1 — collaborative/guide; 2 — teleoperated; and 3 — autonomous. While each of these systems has various benefits and limitations, they all offer the potential to augment or optimize various otologic surgical techniques. We focus on two clinical applications within ear surgery especially suited for robotic incorporation: surgical drilling and insertion of cochlear implant (CI) electrode arrays. Robotic systems for both drilling (minimally invasive tunneled techniques and bulk drilling applications) and CI electrode insertion have been developed to improve current techniques and are discussed throughout this chapter.