The authors present an analysis of a group of 169 myringoplasties and reconstructions of the middle ear implemented in the course of two years (1998-1999). 82 primary, simple myringoplasties were made and 41 re-myringoplasties on account of dry perforation of the tympanic mem- brane. The third group of the evaluated operations is formed by 46 myringoplasties “complicated” by the necessity of treatment of a pathological process in the middle ear and its reconstruction. For plastic operations of the ear drum they use primarily usually a fascial free graft. The perichondrium or chondroperichondrium is used more frequently in reoperations or in concurrent reconstruction of the posterior wall of the auditory meatus. With regard to the technique of a soft transplant the technique of a removable silicone sheet is used, which was the case in 71 (42 %) operations. It serves above all as support of the graft, also to prevent adhesions and for restoration of the mucosa of the middle ear. The use of the silicone sheet increases with the size of the perforation and extent of pathological findings in the tympanic cavity. In the majority of operated ears complete primary incorporation of the graft occurred. The final anatomical results deteriorate as a result of secondary perforations of the neomyrinx as a result of its late trophic changes. After a 6-30-month interval following healed ear developed (integral ear drum, unobstructed middle ear) in 63 (77 %) myringoplasties, 33 re-myringoplasties (80 %) and 38 (83 %) “complicated” myringoplasties. The authors analyze the causes of failure in different types of operations. The decisive factor for the outcome of myringoplasties is a correctly selected surgical technique and experience of the surgeon.

        Key words: myringoplasty, graft material, silicone sheet, results.