Cochlear implantation is one of the most advanced surgeries in the field of otology. It is a hybrid of medical and engineering science. The surgery involves fine placement of electrodes inside the cochlea. Quite often the anatomy may make the things more difficult. This may be in cases of revision surgeries, malformed cochlea, labyrinthitis ossificans etc. Revision surgeries are becoming common as the older implants are failing and also because of more implants being done. This may be due to implant failure or infection or misplaced electrodes. All these indications require good optics to visualize the implant and dissect it off the fibrosis and granulations. Also finding the cochlear lumen may be a challenge in these cases.

All the issues faced during such tricky cochlear implant surgeries can be handled by experience, good equipment and instruments. The presentation deals with importance of all these, specially with various advanced modes of optics available in today’s microscopes. It is paramount to have a good exposure, illumination, focus and zoom to have a successful surgery. In the presentation, there will be cases of cochlear implant surgeries which have gone bad and are now being revised.