Radical mastoidectomy has for years been the method chosen for the treatment of chronic middle ear disease. The numerous inflammatory problems linked to this cavity have been dealt with differently by various authors. We have examined the literature and refer to our own data, from a study carried out in twenty-four subjects, showing unsatisfactory results subsequent to a previous radical mastoidectomy. In ten of these subjects, middle ear cleft reconstruction was performed using a posterior canal wall prosthesis in Ceravital; in the remaining fourteen subjects complete obliteration with costal cartilage and a mixture of bone paté and fibrin glue (Tissucol) was carried out. In both groups the reconstruction of the conductive system was carried out by the insertion of total or partial ossicular replacement prostheses in Plastipore. The comparison of findings in the two groups revealed slightly better functional results in all two-stage procedures and in reconstructions performed with Ceravital. However, the one-stage procedure proved to be equally effective in resolving the inflammatory problems.