In most cases, cochlear implantation is a straightforward procedure. Nevertheless, there are clinical situations in which the presence of the middle ear may compromise access and/or the outcome in terms of complications. This article includes a series of patients for whom we eliminated the middle ear to facilitate placement of the electrode array of the implant and/or reduce potential complications. A total of 92 cases in 83 patients, managed by the senior author, are included in this series. Different indications are outlined that justify associating a subtotal petrosectomy technique with cochlear implantation. The steps of the technique are described. We include complications from this series that compare favorably with standard techniques.
Keywords: Ménière’s disease; chronic otitis media; cochlear implantation; complex cases in cochlear implantation; complications in cochlear implantation; inner ear malformations; petrous bone cholesteatoma; subtotal petrosectomy; temporal bone fracture; vestibular schwannoma.