A standard surgical technique in two stages and a subtotal petrosectomy (SP) in a single stage are the two main choices when dealing with cochlear implantation in simple chronic otitis. As to minimize the risk of tympanic membrane perforation recurrence, SP is the main surgical choice. Nonetheless, surgical strategy varies depending on infection severity: in dry perforations, the standard SP steps are followed; in active infections, extensive mucosa removal is critical. In complex cases, a staged procedure may be indicated, delaying cavity obliteration and cochlear implantation to prevent infection.