Learning Objectives:

Overlay tympanoplasty is one of the well-known techniques of middle ear surgery applied for all types of perforated tympanic membrane. However, classic overlay tympanoplasty has several disadvantages of technical difficulty, lateralization, and anterior wall blunting and long healing time. Modified overlay tympanoplasty was developed to overcome these disadvantages and has been performed for more than 15 years at our university. Overall success rate of this technique was 98%. Precise technique and surgical tips of modified overlay tympanoplasty to achieve a promising surgical result as well as early hearing restoration will be introduced.

Another novel surgical technique of ossiculoplasty, named autologous bone-cartilage composite graft (BCCG) ossiculoplasty will be mentioned. Analytic data of ossiculoplasty of BCCG showed satisfactory hearing outcome and the lowest complication rate among different materials of ossiculoplasty including Polycel^® and titanium. Especially extrusion rate of BCCG ossiculoplasty appeared 0%. Therefore, we propose our BCCG ossiculoplasty be considered as a useful alternative method especially in patients with Eustachian tube dysfunction. Designing procedure and its application to different cases will be demonstrated.