An artificial middle ear prosthesis may be used to replace the ear structure from the bony ear canal up to the oval window of the vestibule. The artificial middle ear includes a tube to replace at least part of the bony ear canal, an annulus to connect an artificial ear drum to the tube, a complex structure to replace the hammer and anvil of a human patient and a piston means connected to the complex structure to replace at least part of the stirrup. According to one embodiment the piston may directly connect the complex hammer/anvil structure to the remaining portion of the oval window of the vestibule. According to another embodiment, the piston may be terminated in a cup shaped socket which will cradle the remaining structure of a stirrup. The bony ear canal tube, the umbo section connecting the complex hammer/anvil structure to the ear drum and the end of the piston directly contacting the stirrup or the oval window are preferably coated with a microporous biocompatible material such as Proplast. The ring or annulus is preferably formed from polytetrafluorethylene or a perfluorinated ethylene propylene polymer. The invention makes it possible to totally eradicate chronic otitis media without sparing the bony ear canal or bony annulus, by replacing the diseased tissues with the prosthesis described.