[The art of tympanoplasty and its clinical illustration]

The development of tympanic membrane surgery is based on 150 years of surgical experiences, medical and technological innovations. There are two major techniques of tympanic membrane reconstruction depending on the graft related to the different anatomic layers of the eardrum.

We evaluate different risk factors of the tympanoplasty such as the age of the patient, the tubal function, the middle ear inflammation, the status of the contra-lateral ear, the localization and the size of the perforation, the surgical techniques and the type of the graft.

We illustrate and comment on those risk factors considering 122 simple tympanoplasties and a large overview of the literature.

We show that the graft position doesn't interfere with the surgical results and we specify our attitude to control the risk factors.

To obtain excellent results, surgical indications have to be extremely rigorous as with surgical techniques.