Objective: The aim of this study was to investigatefunctional results of total ossicular replacement prosthesis (TORP) shaft stabilization with a cartilage shoein chronic otitis media patients with cholesteatomawho had undergone canal wall down tympanomastoidectomy (CWDT). In addition, it was determinedwhether the presence of granular and edematous mucosa in middle ear altered functional outcomes.Methods: Sixty patients, who had undergone CWDTwith the use of TORP for the reconstruction of ossicular chain, were divided into two groups. Patientswith cartilage shoe were classified as Group 1 (n=30)and those without the shoe were classified as Group2 (n=30). Patients in both groups were classified into“A” and “B” subgroups according to the middle ear riskindex (MERI). Air conduction (AC) and bone conduction thresholds were evaluated preoperatively andpostoperatively.Results: There was no statistically significant changebetween preoperative AC thresholds of the groupsand subgroups (p>0.05). There were statistically significant differences regarding AC thresholds and air–bone gap (ABG) values between Groups 1 and 2 atthe postoperative 12th month (p<0.05). PostoperativeAC thresholds and ABG values of Group 1B patientswith a high MERI score were statistically significantat all frequencies than those of Group 2B patients(p<0.05). When ABG values were compared, it wasobserved that functional results were better in Group1B, but a statistically significant difference was observed only at 2000 Hz (p<0.01).Conclusion: The cartilage shoe method for titaniumTORP stabilization that is used for ossicular reconstruction during CWDT has been found to have abeneficial effect on auditory outcomes. Cartilage shoeapplication increases positive effects on hearing outcomes, particularly if the middle ear mucosa is granular and edematous.