Objective: We aimed to underline the surgical importance of the distances between the landmarks of the temporal bone, important for quantifying the benefits and disadvantages of two different cochlear implant techniques. Methods: We have gathered all data from the Radiology Department in Emergency County Hospital in Tîrgu Mureș, namely computed tomography imagistic studies in order to perform the required measurements, according to pre-defined inclusion/exclusion criteria. The time interval was 5 months. Results: The comparison between the sets of data shows a good match for the risk/benefit ratio for the two types of technique for cochlear implantation. Conclusions: The middle cerebral fossa approach for the electrode insertion into the cochlea is a viable and needed surgical technique as the classic approach has reached its boundaries and new challenges appear. As surgical decisions are largely based on radiology data, our work underlines the importance of solving the borderline pathology, the extreme cases and the role of surgery in improving the quality of life for every patient with cochlear implant indication.