<b><br>Aim:</b> The aim of this study was to present the case with a difficult anatomy of the middle ear, in which robot-assisted cochlear implantation via a modified pericanal approach was performed.</br> <b><br>Case report:</b> The patient, a a 63-year-old male, had passed the typical procedure of qualifying for a cochlear implant at our center. However, the preoperative CT of the temporal bones showed a very anterior position of the sigmoid sinus and a very low position of the middle fossa dura in the right ear qualified for cochlear implantation. For this reason, the pericanal approach described by Häusler was chosen. The surgery was performed with the use of a surgical robot - the RobOtol (Collin, Bagneux, France) and the approach was slightly modified. The whole procedure was described in detail in the manuscript. Postoperative CT of the temporal bones confirmed the proper intracochlear position of the electrode array. Both surgery and healing were uneventful.</br> <b><br>Conclusions:</b> The RobOtol surgical robot allows for the correct and safe insertion of the cochlear implant electrode array in patients with unusual anatomical conditions and approach to the cochlea.</br>.
Keywords: cochlear implant; pericanal approach; protruding sigmoid sinus; robot.