TIn middle ear surgery, hearing restoration is the final goal, so ossiculoplasty is one of the most important procedure. Last several decades have witnessed the remarkable progress in method and materials with the advancement of surgical technique. But hearing restoration through ossicular reconstruction was not universally successful due to different ossicular defect and various materials used. Especially the absence of malleus and incus usually raised a difficult problem for the otologic surgeon. Thereafter many authors have used synthetic materials such as proplast, plastipore in ossicular reconstruction, and bioactive, biofunctional material such as ceramic is now being used in Europe recently. We have doubted if any difference in hearing gain between materials used in ossicular chain reconstruction, which lead us to work on it. This study convered the 1,194 ears received middle ear surgery from January, 1981 to December, 1983. The result was as follows ; 1) The number of ears received ossiculoplasty between grafted drum and capitulum, footplate of the stapes or oval window was 227 ears. 111 ears were followed up and mean follow up period was 6.0 months. 2) 55.9% had a postop. air-bone gap less than 30dB. 3) 46.2% of the ears using cartilage, 62.2% of those using ossicle, 68.2% of those using proplast or ceravital had postop. air-bone gap less than 30dB. 4) 50% of the ears received ossiculoplasty between capitulum of stapes and grafted drum using cartilage, 70.4% of those using ossicle, 62.5% of those using PORP had postop. air-bone gap less than 30dB. 5) 38.9% of the ears received ossiculoplasty between footplate of stapes and grafted drum using cartilage, 42.9% of those using ossicle, 66.7% of those using TORP had postop. air-bone gap less than 30dB. 6) 50% of the patients received ossiculoplasty between oval window and grafted drum using cartilage, 33.3% of those using ossicle, 100% of those using TORP had postop. air-bone gap less than 30dB. 7) Autograft had superior result to homograft. 8) 44.1% of the ears received ossiculoplasty had postop. air-bone gap larger than 30dB.