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Background and Objective:Tinnitus is hearing a sound without an external source, which occurs anywhere in the head and one or both ears. It is one of the most common symptoms associated with hearing loss due to chronic otitis media. This study aimed to determine the effect of autologous primary ossicular reconstruction on the recovery of tinnitus due to chronic otitis media. Materials and Methods:This study was conducted based on a before-and-after design and included 25 patients aged 18-70 years with tinnitus and chronic otitis media. The participants had undergone initial reconstruction of the bone chain using an autologous graft in the Department of Ear, Nose, and Throat of the Hamadan Besat Hospital, Hamedan, Iran, in 2019. The Tinnitus Matching Test and the Tinnitus Handicap Inventory were used to assess patients' tinnitus. Results:A total of 25 patients participated in this study, including 13 (52%) men and 12 (48%) women. The mean scores of the age of the subjects, duration of tinnitus, frequency of tinnitus were obtained at 45.76±12.76 years, 53.25±37.25 months, and 5,000 Hz, respectively. The difference between the mean values of tinnitus loudness was significant before (8 dB) and after the surgery (4 dB) (P<0.001). Moreover, a significant difference (P<0.001) was observed between the scores of the Tinnitus Handicap Inventory before (39.48) and after the surgery (17.84). Conclusion:Primary reconstruction of the middle ear bone chain using autologous graft improved tinnitus and its resulting disability in patients with chronic otitis media.