In our hospital, canal down and reconstruction is usually managed in tympanoplasty. There are two main problems for artificial ossicular chain prosthesis; extrusion and postoperative slippage of prosthesis. We manufactured a new hydroxyapatite prosthesis cartilage connecting ossicular chain prosthesis" with a planar-like head portion to contact with a piece of cartilage The cartilage connecting ossicular chain prosthesis” tightly attached with a reconstructed tympanic membrane and ossicular chain prosthesis might be stable in tympanic cavity.