A cochlear implant is an artificial sensory organ for patients with severe to profound hearing loss who have little benefit from hearing aids. The fact that more patients with previous temporal bone surgery or cranial malformations are receiving cochlear implants implies that the number of atypical cochlear implantation will continue to grow. Surgical navigation, or image-guided surgery may be helpful for surgeons who perform atypical surgeries. We report our research on an image-guided system specifically designed for otologic surgery with an improved surgeon-computer interface.