Among the hearing-impaired population requiring cochlear implants, some have cochlear osseointegration. Cochlear osseointegration has been a contraindication to cochlear implantation for a long time, but the incidence of cochlear osseointegration is high in the hearing impaired population; Trinh et al. reported 14% cochlear osseointegration in a sample of 105 cochlear implants (mostly adults). The incidence of cochlear osseointegration is even higher in children, with Luxford et al. reporting 34% cochlear osseointegration in a sample of 128 children. However, with modern medical technology, abandoning these cochlear osseointegrated individuals would make it difficult for many hearing impaired individuals to return to the audible world and lose the opportunity to communicate verbally. Before cochlear implant surgery, hospitals usually perform preoperative imaging, and if cochlear osseointegration is found, the surgeon will usually choose the less osseointegrated side of the ear. In searching the literature, China Hearing Online found that cochlear ossification accounts for about 10% to 15% of cochlear implant recipients and about 80% of meningitis-induced deafness recipients. It is commonly seen in meningitis, otosclerosis, autoimmune disease of the inner ear, temporal bone fractures, otitis media, leukemia and temporal bone tumors, and other causes of deafness. Temporal bone pathology shows that, regardless of the cause of deafness, the site of cochlear ossification often begins at the base of the cochlea back to the tympanic level, which may be related to the fact that inflammation (inflammation of the subretinal cavity reaches the tympanic level via the cochlear aqueduct inflammation of the middle ear reaches the tympanic level via the cochlear window) is more likely to invade the tympanic level. The degree of cochlear ossification can range from fibrosis to complete ossification, but only a very small percentage of hearing impaired people have complete cochlear ossification. The reason that cochlear ossification was once a contraindication to cochlear implantation is that it is difficult to implant electrodes in an ossified cochlea, and even if implanted, the electrodes may be damaged or the inner ear structure may be destroyed. It is doubtful that multiple electrodes can effectively stimulate the residual nerve component in an ossified cochlea. The residual neural component in the ossified cochlea is unclear. However, recent medical studies found that histopathological examination of the temporal bone confirmed that although the number of hair cells and spiral ganglia in the ossified cochlea was reduced, the number of spiral ganglia remaining in even severely ossified cochlea was significant, and that only 10% of spiral ganglion cells remaining could still produce effective hearing after cochlear implantation. There is no definite relationship between the degree of labyrinth ossification, tympanic obstruction, and surviving spiral ganglia. Since cochlear electrodes stimulate spiral ganglia and axons, the survival of spiral ganglia and axons provides the theoretical basis for cochlear electrode implantation in the ossified cochlea. With the development of cochlear implantation technology and advances in speech processor coding strategies, physicians have accumulated some experience in cochlear implantation and postoperative hearing and speech rehabilitation of ossified cochlea. Depending on the degree of cochlear ossification, the appropriate surgical approach is taken, and most of the electrodes can be implanted all the way into the cochlea. Sodium hyaluronate is also injected into the cochlear canal for irrigation, which not only helps to remove the bone powder in the cochlear canal, but also plays a role in lubricating the smooth implantation of the electrodes and reducing the damage of the electrodes to the cochlear structure. Balkany et al. reported that 91% of partially osseointegrated cochlea patients with post-speech deafness achieved closed speech recognition and 75% achieved open speech recognition. The results were similar to those of other causes of deafness after cochlear implantation. This suggests that multichannel electrodes are effective in stimulating the residual neural component in the ossified cochlea. A paired analysis of the speech recognition abilities of prelingually deaf children with and without cochlear ossification at 6 and 12 months after cochlear implantation has also been published, and although the speech recognition abilities of children with cochlear ossification were still worse than those of children without cochlear ossification after surgery, they were significantly better. Although cochlear implantation is a difficult procedure when the cochlea is ossified, electrode implantation can still be done through the conventional mastoid fossa approach when the cochlea is ossified, and electrode implantation can be done completely in the cochlea when the cochlea is mildly ossified, with minimal damage to the electrodes and good postoperative hearing results.