The study compared two methods of steroid administration after stapedectomy in patients with otosclerosis - oral prednisone and topical dexamethasone. A retrospective study included 76 patients operated on between 2016 and 2024, with 37 receiving oral prednisone (50 mg daily for 5 days) and 39 receiving topical dexamethasone applied intraoperatively. Both groups demonstrated significant improvement in air-conduction hearing and comparable air-bone gap closure without significant differences. A greater increase in bone conduction was observed in the oral steroid group. Postoperative tinnitus and infections occurred more frequently in the topical steroid group, whereas the incidence of dizziness was similar between groups. The authors conclude that both routes of steroid administration resulted in comparable improvements in hearing outcomes, although oral steroids were associated with better bone conduction recovery and fewer complications. However, they recommend interpreting the findings with caution given the retrospective study design and limited sample size.