General anesthesia was only used for the procedure, and intravenous antibiotics were given before the surgical incision. Electrode impedance testing and nerve response telemetry (NRT) are performed after implantation of electrodes. EBAR monitoring and facial nerve monitoring are used in special cases such as inner ear malformations. The majority of surgical approaches are made using a facial saphenous approach. A retroauricular incision is usually used. The incision is divided into two layers, a superficial subcutaneous skin layer and a deep temporalis fascia layer. The entire flap is turned backward to expose the mastoid bone cortex. An electric drill is used to grind the stimulator bone bed on the skull surface above the posterior mastoid process. A simple mastoidectomy is performed to expose the short pedicle of the anvil bone, which is used as a marker to open the facial fossa, and the cochlear tympanic step is opened below the round window niche. The receptive stimulator is inserted into the bone bed, the stimulating electrode is inserted into the cochlear tympanic step, and the reference electrode is placed on the skull surface under the temporalis muscle. The surgical approach is modified accordingly for cases of cochlear malformation (e.g. Mondini malformation, common cavity malformation) and cochlear ossification. The main surgical complications include wound infection, flap necrosis, facial palsy, meningitis, and electrode prolapse. Infections of the middle ear usually do not affect the implanted device and can be controlled with conventional methods. A small number of people with implanted electrodes in the cochlea experience mild vertigo after surgery, which mostly disappears on its own within a few days.