Children deprived of hearing sensation in the formative period of first 6 years cannot develop speech. Hence the need to identify the deafness early and to treat it within the shortest possible time becomes imperative Modern developments in this field have centered on early identification of the deafness and correction. If the deafness is only moderate a regular hearing aid will suffice. When the loss is profound then there is a need to implant the child with cochlear implant. Various implants have been designed and developed by many companies. Most of the implants require to drill a well in the skull bones to place the internal processor which is needed for preventing implant migration. This is time consuming and difficult to the surgeon as seen in the figure 1.

In addition during well drilling more soft tissue retraction has to be done with a risk of dural injury. The cochlear company device requires in addition holes to pass tie down sutures with Teflon tapes. A French company NEURELEC have designed MXM implant (technical support in India provided by Alps) with no need to drill skull bone and instead secures the internal processor by placing two titanium screws as seen in figure 2, Surgeons need to keep moving with the trends of technological advance. In our institute we have the experience of using the Nucleus and MXM cochlear implants. We have found a reduction in surgical time by 30 to 45 mins with the use of MXM implant and achieving the same results.