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The outtakes of this HEARRING Round Table event are the following: All surgeries should be performed using the hearing preservation principles: no suction near the cochlea, round window approach whenever possible, slow insertion of the electrode, possibly steroids. Genetics play a very important role in the diagnosis and management of patients with residual hearing undergoing cochlear implantation. Preserved hearing may deteriorate and even disappear over time, which is important from the counselling point of view. We have to use the least traumatic electrode possible, such as the long, thin and flexible one. The complete cochlear coverage should be considered, especially if the preserved hearing is deteriorating. From the standpoint of the patient, hearing preservation is very important for their daily life. But the concept of structure preservation is even more important for the future: the more structures we preserve today, the more options will our patients have tomorrow. This event will shortly receive international accreditation from the CPD Standards Office: https://www.cpdstandards.com/