ObjectiveTo investigate the application and therapeutic effect of epitympanoplasty with cartilage obliteration and canal wall up procedure in the surgical treatment of otitis media.Methods45 cases of middle ear cholesteatoma and 13 cases of active otitis media were included in our study. After mastoidectomy with preserved posterior canal wall, resection of the lateral wall of epitympanum, and opening of the facial recess as well as removal of the lesions in these regions, epitympanoplasty with cartilage obliteration was performed in all the patients. The patients were followed up for 12 to 36 months postoperatively for evaluation of therapeutic outcomes including recurrence of cholesteatoma, morphology of tympanic membrane and hearing improvement.ResultsThe connection between the reconstructed lateral wall of epitypanum and the preserved posterior canal wall was established in all 58 patients. Postoperative swelling or skin defect of the canal wall occurred in 6 cases and got cured with subsequent dressings for 4 to 5 times. 3 cases experienced light discharge with marginal perforation of tympanic membrane and got delayed healing by local drug therapy. Exclusion of the ossicular replacement prosthesis and secondary perforation of tympanic membrane were observed in 3 and 2 patients respectively. Recurrence of cholesteatoma was found and cured with traditional mastoidectomy in 2 patients. At 6 months after operation, all the patients presented hearing improvement in different extent including decrease of average airbone gap at 0.5, 1k and 2k Hz by 10 dB, and improvement of average air conduction hearing threshold by about 15 dB.ConclusionsFor the surgical treatment of otitis media, the epitympanoplasty with cartilage obliteration and canal wall up procedure can provide not only fully exposure and removal of the lesions but also the intact of posterior canal wall to effectively prevent the formation of retraction pocket in attic. This technique can decrease recurrence of cholesteatoma and avoid large surgical cavity in canal wall down technique. With perfect recovery of tympanic morphology, hearing preservation and improvement can be obtained.