Objective To investigate the clinical effect of the reconstruction of the lateral wall of upper tympanum with perichondrium-cartilage-perichondrium complex in the operation of cholesteatoma of upper tympanum (including cholesteatoma of external auditory canal and cholesteatoma of middle ear) under otoscopic perfusion mode.Methods In the study, a retrospective analysis was performed on 29 patients (14 cases of cholesteroma in the external auditory canal and 15 cases of cholesteroma in the middle ear), all of whose upper tympanum was all invaded and destroyed by cholesteatoma. After the lesions of upper tympanum and ossicular chain were completely removed, the perichondrium-cartilage-perichondrium complex of tragus or concha cavity was selected to reconstruct the lateral wall of the upper tympanum by otoendoscope under perfusion mode.Results The air conduction hearing were (42.51±3.55) dBHL before operation and (26.22±5.12) dBHL three months after operation. The air-bone conduction difference was (28.67±6.31) dBHL before surgery and (13.11±6.56) dBHL three months after surgery. And there were statistically significant differences between them(P all<0.05). After regular follow-up, tinnitus occurred in 5 cases, vertigo in 3 cases, invagination bag in 1 case and prolapse of artificial ossicular prosthesis in 1 case, external auditory canal stenosis in 3 cases and tympanic membrane perforation in 1 case. After symptomatic treatment, the symptoms of tinnitus, ear tightness and vertigo disappeared, and the hearing of patients with invaginated bags and prolapse of artificial ossicular prosthesis was still improved. After further observation and follow-up, the perforation of tympanic membrane and stenosis of external auditory canal were cured after surgical treatment again.Conclusion The perichondrium-cartilage-perichondrium complex under otoendoscopic perfusion mode can reconstruct the lateral wall of upper tympanum and restore the anatomical structure of middle ear tympanum after cholesteatoma removal, which can significantly improve the postoperative hearing of patients, promote the postoperative recovery of patients and reduce the incidence of postoperative complications.