Cochlear implantation is the therapy used for patients with severe to profound sensorineural hearing loss. For the success of the surgery, it is important that each surgical step is performed with meticulous precision, starting from the correct patient’s position on the operating table. In elderly or obese patients, this can be difficult to achieve due to cervical rigidity. In these cases, the orthopedic position is an excellent choice to perform a mastoidectomy accurately, ensuring a safe procedure and avoiding unpleasant complications.