Background: The need for cochlear reimplantation has grown significantly in recent years. This study presents a case series on minimally invasive cochlear reimplantation using the Bremen Approach (BA). The objective was to assess the suitability of using the same minimally invasive approach for patients requiring reimplantation after the initial cochlear implantation. Material and methods: In a retrospective case series spanning from 2015 to 2023, 11 patients, aged 8 to 85 years (mean 62, SD ± 27), underwent cochlear implant revisions due to device malfunction. All patients were treated using the BA approach. The study assessed surgical trauma, operation time, causes of device malfunction, malfunction onset timing, complications, and featured a follow-up 6 to 12 months later, utilizing the original incision scar for mastoid cavity reopening. Results: The study revealed a median diagnosis time of 33 months for implant failure. In 9 of 11 cases, a single manufacturer's device was affected, and in 6 cases, the initial incision didn't need widening. Initial incision length averaged 26.0 mm (ranging from 25 to 30 mm), closing at 30.6 mm (ranging from 25 to 45 mm). Mastoid drilling dimensions were 10.9 mm anterior-posterior (ranging from 7 to 18 mm) and 13.1 mm cranio-caudal (ranging from 8 to 30 mm). Surgical time averaged 80.6 minutes (ranging from 42 to 131 minutes, SD ± 23.6). Reimplantation involved the same device type in 10 of 11 cases, with no long-term complications. Conclusion: The BA is suitable for both primary minimally invasive cochlear surgery and safe for reimplantation. Most revisions required minimal modifications and were quicker than the initial surgeries. The higher number of revisions for one device type was due to a specific technical issue.

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