Paulina Podlawska-Nowak

Objectives: The aim of this study was to compare the surgical and postoperative clinical outcomes of punch-only and linear incision techniques for implantation of the Ponto^® bone conduction implant. Methods: Surgical and follow-up data were collected from 101 patients: 46 treated with Minimally Invasive Ponto^® Surgery (MIPS) and 55 with the linear incision technique (LT). The analysis focused on: (1) the surgical procedure, including operative time and intraoperative complications; (2) the healing process; and (3) long-term implant-site outcomes, including implant loss. Results: Median operative time was significantly shorter for MIPS than for LT (30 min vs. 40 min, p < 0.001). No major intraoperative complications were observed in either group. Adverse skin reactions were more frequent in the LT group than in the MIPS group (18.2% vs. 8.7%), but the difference was not statistically significant (p = 0.249). A single implant loss occurred in the LT group 18 months after surgery and was unrelated to failed osseointegration or the surgical technique, being caused by recurrent cholesteatoma. Conclusions: MIPS was associated with a significantly shorter operative time than the LT. Both MIPS and LT appear to be safe techniques. No statistically significant differences were detected between the groups with respect to adverse skin reactions or implant survival during the follow-up period.

Introduction: Access to oncology care in Poland remains uneven, with rural residents limited to specialist availability. We analyzed geographic factors that may worsen cancer outcomes and deepen health disparities in Poland between rural and urban inhabitants. Objectives: This study aims to evaluate the impact of geographic and demographic factors on cancer diagnosis in central Poland, focusing on disparities between urban and rural populations. Methods: A retrospective cohort analysis was conducted on 4,771 patients suspected of having cancer at the Nikolay Pirogov Specialized District Hospital in Łódź between 2020 and 2024. Clinical records and public health datasets were analyzed. Logistic regression was used to assess associations between cancer diagnosis and variables such as distance to the nearest hospital, residence type (urban vs. rural), age, and sex. Models were adjusted for potential confounders. Results: Of the 4,771 patients evaluated, 2,996 (62.8%) received a cancer diagnosis and 1,775 (37.2%) did not. In multivariable models, living 5–10 km from the hospital (vs. 10 km and urban/rural status did not demonstrate independent effects after adjustment. These findings are hypothesis-generating and should be interpreted as indicators of potential access pathways among hospital-admitted patients, rather than causal effects. Targeted interventions (e.g., mobile diagnostics, transportation support, and optimized referral pathways) warrant evaluation.

We report a case of a 74-year-old patient with Arnold–Chiari syndrome (type 1) who, due to the bilateral profound hearing loss, was qualified for cochlear implantation. The difficult anatomy of the temporal bone necessitated special preparation for the procedure. The use of neuronavigation, in combination with facial nerve monitoring, enabled a safe surgical approach to the cochlea and ensured accurate placement of the implant.Cite this article as: Podlawska-Nowak P, Bartochowska A, Balcerowiak A, Gawęcki W. Cochlear implantation in patient with Arnold–Chiari malformation. J Int Adv Otol. 2025, 21(2), 1273, doi: 10.5152/iao.2025.231273.

Robotics in otology has been developing in many directions for more than two decades. Current clinical trials focus on more accurate stapes surgery, minimally invasive access to the cochlea and less traumatic insertion of cochlear implant (CI) electrode arrays. In this study we evaluated the use of the RobOtol^® (Collin, Bagneux, France) otologic robot to insert CI electrodes into the inner ear with intraoperative ECochG analysis. This prospective, pilot study included two adult patients implanted with Advanced Bionics (Westinghouse PI, CA, USA) cochlear implant, with HiFocus™ Mid-Scala electrode array. The standard surgical approach was used. For both subjects, who had residual hearing in the implanted ear, intraoperative and postoperative ECochG was performed with the AIM^TM system. The surgeries were uneventful. A credible ECochG response was obtained after complete electrode insertion in both cases. Preoperative BC thresholds compared to intraoperative estimated ECochG thresholds and 2-day postoperative BC thresholds had similar values at frequencies where all thresholds were measurable. The results of the ECochG performed one month after the surgery showed that in both patients the hearing residues were preserved for the selected frequencies. The RobOtol^® surgical robot allows for the correct, safe and gentle insertion of the cochlear implant electrode inside the cochlea. The use of electrocochleography measurements during robotic cochlear implantation offers an additional opportunity to evaluate and modify the electrode array insertion on an ongoing basis, which may contribute to the preservation of residual hearing.