Transmuscular pocket: a modified technique to overcome thick musculocutaneous flap in cochlear implant surgery.

To describe and evaluate a modified cochlear implant surgical procedure for patients with a thick musculocutaneous flap. A prospective study for cochlear implant surgery in selected patients with a musculocutaneous flap thicker than 7 mm. Fourteen patients with a thick scalp flap underwent cochlear implantation between July 2019 and December 2020. The patient age ranged between 17 and 53 years. The flap thickness was between 7 mm and 14 mm. The mean follow uptime post operatively was 16.5 months. The cochlear implant receiver coil was successfully implanted using the transmuscular technique without complications and with normal audiological function. The transmuscular pocket modified technique is a safe and effective method to overcome a thick musculocutaneous flap in cochlear implant surgery.