Sensorineural hearing loss following temporal bone fractures involving the otic capsule represents a common indication to cochlear implantation. Nevertheless, those cases may be complicated by various factors, including delayed diagnosis, cochlear ossification, dislocated anatomical landmarks, and risk of intracranial infection through fibrous-healed fracture lines. Subtotal petrosectomy (SP) is often the preferred approach, allowing safe cochlear access, management of an eventual facial nerve damage, and isolation of the middle ear from potential contaminants. Furthermore, a complete electrophysiological evaluation, such as the promontory test, is critical to assess spiral ganglion viability and guide candidacy in the preoperative phase.