Cochlear implantation is an effective method for the treatment of severe and extremely severe sensorineural hearing loss, and it has been widely used clinically. At present, the commonly used surgical method is mastoidectomy via transfacial recess approach. In order to achieve minimally invasive, precise, and low-injury cochlear implantation, there have been researches on direct cochlear access and robotic cochlear implantation. However, there are still problems such as low drilling accuracy and facial nerve damage. This article reviews issues related to direct cochlear pathways in cochlear implantation, application of robotics, precision and risks of channel drilling.