Abstract: Objective: A series of otitis media patients with Austin A and C type ossicles defects received ossicular chain reconstruction surgery using either autologous incus or titanium partial ossicular replacement prosthesis (PORP). The hearing outcomes and exclusion rate of prosthesis were compared between these two groups.Method: One hundred and seventy-six patients with chronic otitis media underwent ossiculoplasty in our hospital during 2016-2017. These patients were divided into 2 groups:group A consisted of those receiving autologous incus replacement (n=85), and group B consisted of those receiving titanium PORP (n=91). All the patients received CWD mastoidectomy and ossiculoplasty in one stage and were followed-up in postoperative 3, 6 and 12 months.Result: The postoperative hearing improvement rates in group A and B were 85.88% and 92.31%, respectively, and there was no statistical difference. No statistical difference of the postoperative hearing improvement rates was observed between Austin A and C type in 2 groups. Three cases (3.29%) had ossicle exclusion in B group, and 0 case in A group, which was not statistical different (P>0.05).Conclusion: Patients receiving ossicular chain reconstruction surgery using autologous incus show similar hearing outcomes as those using titanium PORP. The risk of prosthesis exclusion is lower for autologous incus than titanium PORP. The residual handle of malleus has no obvious influence on the postoperative hearing improvement.