Cochlear implantation is becoming more widespread. From its early days to date, huge strides have been made in the technology and surgical technique. However, one challenge remains: implanting malformed or abnormal cochleae. Even more challenging is a cochlea that appears normal at first glance, but is not. We present a case of a child with chondrodysplasia punctata, who had apparently morphologically normal inner ears, but with one major obstacle: the cochlea was smaller than normal in all dimensions. To the best of our knowledge, this is the first case described, and the solution is a novel one as well.