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Abstract The microscopic transmastoid posterior tympanotomy approach is the gold standard approach for CI During CI, RWM insertion is superior than cochleostomy insertion Anatomical variations of the mastoid aeration, facial nerve, cochlear rotation, and round window niche may render the RWM approach through posterior tympanotomy challenging The combined microscopic transmastoid plus endoscopic transcanal approach provides superior RWM exposure, improved electrode handling, and increased chance of full electrode insertion. This approach can handle any difficult case for RWM visibility through posterior tympanotomy whatever the cause. It can be used in contracted mastoid, narrow posterior tympanotomy, and rotated cochlea. The endoscope provides the ability to have a second look after insertion of the electrode to. |