approaches in management of conductive hearing loss

Background: Ossiculoplasty is a key surgical procedure for restoring hearing in patients with conductive hearing loss caused by ossicular chain disruption. Objective: To compare hearing outcomes, operative time, and postoperative complications between postauricular and transcanal ossiculoplasty approaches Methods: A prospective randomized comparative study was conducted on 60 patients with conductive hearing loss secondary to ossicular chain abnormalities. Patients were randomly allocated into two equal groups: postauricular ossiculoplasty (n = 30) and transcanal ossiculoplasty (n = 30). ABG was measured at 500, 1000, and 2000 Hz, and pure tone audiometry was done both before and after surgery. Operative time and postoperative complications were recorded. Paired and independent t-tests were used for statistical analysis, with a significance level of p < 0.05. Results: Both groups demonstrated significant postoperative improvement in ABG compared with preoperative values (p < 0.001 for each group). The mean postoperative ABG was 35.0 ± 5.5 dB in the postauricular group and 36.3 ± 5.4 dB in the transcanal group, with no statistically significant difference between groups (p = 0.351). Hearing improvement was achieved in 86.7% of patients in the postauricular group and 96.7% in the transcanal group (p = 0.112). Operative time was significantly shorter in the transcanal group (3.33 ± 0.09 h) compared with the postauricular group (4.12 ± 0.08 h) (p < 0.001). No postoperative complications were reported in either group. Conclusion: Both postauricular and transcanal ossiculoplasty approaches provide significant and comparable hearing improvement in patients with conductive hearing loss. .