The exclusive transcanal approach proved to be faster, simpler, and safer in comparison to the classic surgical technique through the facial recess, reducing the risk of chorda tympani and facial nerve lesions. All the patients and, in particular, those operated placing the FMT on the round window achieved improvements in hearing thresholds and speech perception tests from the use of the VSB. Moreover, after a mean 21-month follow-up (range, 15-32 mo), we did not observe any complication such as tympanic membrane perforations, external ear canal skin lesions, or extrusion of the coil in the external ear canal.

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