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Surgery was performed with ossicular chain disarticulation on an as\u2010needed basis using either ossicular chain preservation (without ossicular disarticulation), incudostapedial separation, or incus disarticulation technique. Hearing outcomes were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 108 patients were included in this study. Among these, 89 patients underwent ossicular chain preservation, 5 underwent incudostapedial separation and 14 underwent incus repositioning. The proportion of patients with a change in the 4\u2010frequency air conduction pure\u2010tone average of less than 10\u00a0dB was 91%, 60%, and 50%, respectively, for the three surgical techniques; these were significantly different (Fisher's exact test, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Frequency\u2010specific analysis showed that air conduction was significantly better following the ossicular chain preservation technique compared with the incus repositioning technique at stimulation frequencies lower than 250\u2009Hz and higher than 2000\u2009Hz, and compared with the incudostapedial separation technique at 4000\u2009Hz. Analysis of biometric measures determined on CT images suggested that the feasibility of the ossicular chain preservation technique correlates with incus body thickness on coronal CT images.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ossicular chain preservation is an effective approach for hearing preservation in transmastoid facial nerve decompression or similar surgical procedures.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.1001","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T11:10:59Z","timestamp":1672139459000},"page":"185-191","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Frequency\u2010dependent hearing outcomes with or without preservation of intact ossicular 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