Several tympanoplasty techniques using ""swing-door"" method that was originally described by Palva have been modified by many otologic surgeons. The basic techniques are as follows. After designing the superiorly-based and inferiorly-based external auditory canal skin flaps, those are rotated anteriorly to maximize the surgical exposure of the middle ear cavity. Then, the surgeon can secure the exact position of the tympanic membrane graft under the anterior tympanic membrane remnant more easily. The modifications of this technique are 1) getting better surgical exposure with the positioning of those two flaps more anteriorly, 2) getting better security of tympanic membrane graft by wrapping the malleus handle with the incised graft, and 3) lessening the possibility of anterior graft detachment with the procedure through the tympanic membrane perforation. Of a series of 218 ears operated on with this technique, 94.5% graft take up rate was observed at 3 months postoperatively and cochlear damage was not noted in all cases which could be evaluated with postoperative audiogram. So these results indicated that this technique would be one of the excellent tympanic membrane grafting methods.