The aim of this work is to present a modified transcanal technique for cochlear implantation. It was a prospective study on 125 cochlear implant patients presenting to two tertiary referral hospitals between January 2010 and January 2013 and followed up for 6–30 months. Their age range was 2–56 (mean 3.4 years) and the male: female ratio was of 2.1？:？1. A modified transcanal technique was adopted through a small postauricular incision. A tympanomeatal flap is elevated, the middle ear is exposed, and the round window membrane is exposed by drilling the overhanging niche. The electrode is channeled in an open trough along the posterosuperior meatal wall, which is reconstructed by autologous cartilage. The round window was used for insertion in 110 patients and a cochleostomy in 15. The main outcome measures were technical steps, operative time, and ease and completeness of electrode insertion. The actual surgical time (excluding device testing) ranged between 25 and 40 minutes (mean 30.1？min). There were 115 complete insertions and 10 partials. There were 6 chorda tympani injuries, 2 electrode exposures with 1 requiring revision, and 2 cases with a tympanic membrane perforation which were grafted uneventfully. One case had severe infection with extrusion of the device 1 year after successful implantation. 1. Introduction Cochlear implants have a well-established field track of hearing rehabilitation. In addition to severe and profound sensorineural hearing loss, the indications for cochlear implants have been extended over the past few years (younger age at implantation, bilateral implantations, single sided deafness, hearing preserving techniques, and electroacoustic devices) [1–4]. The number of cochlear implant candidates has thus grown tremendously [5, 6]. This will naturally lead to the need for more trained surgeons in more centers to be able to cope with this increasing workload. The standard mastoidectomy-posterior tympanotomy has been the gold standard for cochlear implantation for decades. However it does have its disadvantages and complications [7–11]. This stimulated many workers to modify their approach to a more “surgeon-friendly” approach which is adaptable to most of the possible situations with minimal morbidity, comparable efficiency, and shorter operative time [12–21]. We present our modification of the transcanal approach outlining the technique, its advantages, and our results. 2. Patients and Methods This study includes 125 cochlear implant patients who were implanted between January 2010 and January 2013 and followed up from 18 to
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