This article presents a comprehensive analysis of current surgical strategies for the management of chronic otitis media (COM), emphasizing the evolution of techniques aimed at eradicating infection, restoring middle ear function, and improving hearing outcomes. Chronic otitis media remains a major otologic condition characterized by recurrent or persistent inflammation of the middle ear and mastoid cavity, often resulting in tympanic membrane perforation, ossicular chain disruption, and conductive hearing loss. The study reviews and compares classical and modern surgical methods, including tympanoplasty, mastoidectomy, ossiculoplasty, and combined approaches, with special attention to endoscopic ear surgery and minimally invasive techniques. The findings highlight the advantages of endoscopic visualization, cartilage grafting, and biocompatible prosthetic reconstruction in improving anatomical integrity and auditory performance. The results confirm that the integration of traditional microsurgical precision with modern technological innovations provides superior functional and cosmetic outcomes while reducing postoperative morbidity and recurrence rates
