In the course of eight years the authors made several types of myringoplasties. In 97% a fascial graft was used with a premyringeal or retromyringeal approach. In small central perforations stepp plasty proved useful, in major defects a combination of stepp plasty and placement of the graft beneath the tympanomeatal lobe or beneath the skin of the auditory meatus resp. Anatomical healing was achieved in a total of 90%. Eight per cent of the patients were re-operated with satisfactory results. After simple myringoplasties the auditory gain was 15-20 dB in 90%, after reconstruction of the entire conduction system hearing improved markedly in 64%. Hearing did not deteriorate after operation in any of the patients.