**1. Introduction**

Cochlear implantation (CI) is the surgical implantation of an electrical device that can directly stimulate the auditory nerve through bypassing a nonfunctional inner ear. Through this device, speech and other sounds can be heard by severe to profound deaf people [1].

The first "true" CI was performed by William House and John Doyle on January 9, 1961; the surgery was performed through postauricular incision using mastoidectomy posterior tympanotomy approach (MPTA) to the middle ear. The electrode array was inserted then, after exposure of the round window (RW) membrane, into the scala tympani [2].

Interestingly, the surgical approach used and described by William house in 1961 became the classic or the standard approach for CI; for more than half a century, there was no major advancement or change in the surgical approach. However, there were different alternative approaches and some technical advancements, each of them having relative advantages and disadvantages.
