Learning Objectives:

Objective: To evaluate the choice of microsurgical treatment modalities and it`s clinical effect on middle ear cholesteatoma and chronic suppurative otitis media.

Methods: 110 cases with middle ear and mastoid lesions including middle ear cholesteatoma and chronic suppurative otitis media were analysed which performed canal wall up mastoidectomy or at the same time tympanoplasty and canal wall down mastoidotympanectomy depending on lesion extent and followed-up, observed the ear recovery, complications, recurrence and postoperative hearing improvement.

Results: 110 cases including 66 cases of middle ear cholesteatoma, 44 cases of chronic suppurative otitis media, 51 canal wall up mastoidotympanectomy, 46 cases simultaneously followed by tympanoplasty, 59 canal wall down mastoidectomy, Intraoperative finding as followed auditory absence of bone destruction 36 cases including 7 cases of chronic suppurative otitis media, 29 cases of middle ear cholesteatoma; 7 cases of complete auditory ossicles including 4 cases of chronic suppurative otitis media, 3 cases of middle ear cholesteatoma; facial nerve canal bone destruction 22 cases, brain palate damaged and meningitis exposed in 13 cases.

Conclusion: According to different lesions of middle ear and mastoid the specific disease in intraoperative, different operative methods can be used to obtain the corresponding clinical curative effect, the canal wall up mastoidectomy plus tympanoplasty, if indications mastered properly, the technical conditions permitted, can effectively keep the original middle ear mastoid anatomical structure and improve hearing skill, and this surgery is feasible; if tympanoplasty cannot be used to a wide range of middle ear cholesteatoma, canal wall down mastoidectomy should be preferred in order to avoid recurrence and affect the efficacy.