Objective To observe the effect of tympanoplasty with soft-wall reconstruction of ear canal in the treatment of cholesteatoma otitis media, and to explore its effecton hearing reconstruction. Methods A total of 100 patients with cholesteatoma otitis media admitted to our hospital from January 2019 to January 2021 were selected and divided into control group and observation group according to odd and even number method, with 50 cases in each group. The control group was treated with open mastoidectomy, and the observation group was treated with tympanoplasty with soft-wall reconstruction of ear canal. The therapeutic effct, postoperative air-bone gap, air conduction hearing threshold and prognosis were compared between the two groups. Results The total effectiverate of the observation group was 94.00%, which was higher than 80.00% of the control group, and the diffrence was statistically signifiant (P<0.05). The air-bone deviation and air-conduction hearing threshold of the two groups were lower than those before operation, and the air-bone deviation and air-conduction hearing threshold of the observation group were lower than those of the control group, and the differenceswere statistically significant(P<0.05). The postoperative dry ear rate in the observation group was 84.00%, which was higher than that 32.00% in the control group; the postoperative scab rate and recurrence rate in the observation group were 10.00% and 2.00%, respectively, which were lower than those 64.00% and 18.00% in the control group (P<0.05). Conclusion The tympanoplasty with soft-wall reconstruction of ear canal is effectivein the treatment of cholesteatoma otitis media, which can improve the hearing level, and has good prognosis and low recurrence rate. It is a safe treatment plan.