Objectives: Cochlear implant is the only solution of profound sensorineural hearing loss. The round window implant provides minimal injury to the inner ear, and may preserve the residual hearing, and the key to insert the electrode array is to expose the round window, but displaced facial nerve may hinder the visualization of the round window. The aim of the study was to expose the round window and preserve the full function of facial nerve with endoscopic assistant. Design: Cases with variant facial nerve were observed with rigid endoscopy. The locations of round window were assessed by endoscopy and we performed retrofacial approach, or using “suspended” facial nerve technology to expose the round window by shifting the facial nerve posteriorly. Paticipants: Three cases were collected with variant facial nerve, two cases performed retrofacial approach, one case performed “suspended” facial nerve technology. Results: All cases inserted electrode array in round window and preserve the residual hearing, and none of the cases suffered facial nerve injury, chorda tympani nerve injury, misplacement of the electrode array, and other complications. Conclusion: Rigid endoscopy can provide a clear vision of round window, and assistant the electric array insertion during cochlear implant surgery.