Objective To explore the clinical effect of implantation of autogenous incus and titanium artificial ossicles in the tympanoplasty.

Methods The data of 66 patients with non-middle ear cholesteatoma and underwent tympanoplasty using autogenous incus, and 30 patients with middle ear cholesteatoma and underwent tympanoplasty using titanium artificial ossicular for the reconstruction of ossicular chain, were retrospectively analyzed. The postoperative air-bone gap (ABG) ≤ 20 dB hearing loss (HL) was regarded as the successful standard of the operation. The follow-up time was 6-34 months, with an average of 21 months. The surgery related complications and the hearing efficacy were analyzed.

Results All 96 patients had dry ears at 6-8 weeks after operation. There were no adverse events such as external auditory canal stenosis, granulation growth, and recurrent cholesteatoma. All cases of tympanic membrane repair film grew well, and perforation, displacement, or dislocation of the ossicular prosthesis was not observed. The success rate of the autogenous incus group was 77.2%(51/66). The hearing improvement was not obvious in 3 cases, and 1 patient with secondary secretory tympanitis was cured after the tympanic membrane incision and catheterization in the autogenous incus group. The success rate of the titanium artificial ossicular group was 76.6%(23/30), and the hearing improvement was not obvious in 1 case.

Conclusions For the non-middle ear cholesteatoma patients with infect and good-activity malleus and stapes while the anvil had different extent of destruction or interruption, the autogenous incus bridge could be used as an alternative method for the reconstruction of the ossicular chain. For the middle ear cholesteatoma patients with complete and good-activity malleus and stapes floor, while the structure of the incus and stapes plate had different degrees of damage or interruption, the titanium artificial ossicles implantation reconstruction could be used as an alternative method for the reconstruction of the ossicular chain.