The concept of tympanoplasty was introduced by Wullstein in the early 50's. Different materials for tympanic membrane repair and for ossiculoplasty had been described since then. From 1989 to 1997 we documented more than 7.200 cases of reconstructive middle ear surgery on a computer based documentation system. These data were analysed to compare different materials for the reconstruction of the tympanic membrane (ie. perichondrium, cartilage palisades and cartilage-perichondrium-composite graft). Another important factor that influences the sound conduction mechanisms through the middle ear is the prosthesis. Based on the pooled data the patient’s population was divided into subgroups to work out the influence of different prosthesis on postoperative Hearing. The results of an ongoing clinical studies using a new titanium prosthesis are discussed in comparison to the other prosthesis which we tried. Also a more detailed analysis of the data works showed which prosthesis and which material for the repair of tympanic membrane should be combined to give better results for our patients