Robotic-assisted gynecologic surgery associated tympanic membrane perforation: A report of two cases and review of the literature

•Robotic surgery is increasing in prevalence and carries unique surgical risks related to steep Trendelenburg.•Tympanic membrane perforation is a previously undescribed complication of robotic gynecologic surgery.•We present two cases of TM perforation in elderly patients during robotic surgery.•We believe steep Trendelenburg can cause increased inner ear pressure and increase risk of tympanic membrane barotrauma.•Old age and hypertension seem to be risk factors of TM barotrauma.