[Tympanic membrane repair with cartilage and double tissue-layered grafts (author's transl)]

This article describes the technique and advantages of a three layered repair of large perforations of the tympanic membrane using a pallisade of tragal cartilage covered by temporalis fascia and pedicled external auditory canal skin. Large defects of the tympanic membrane can be closed by this method and in addition satisfactory sound transmission can be achieved. The correct positioning of the cartilage graft complex requires training and skill, but an experienced otologist should be able to achieve this in a short time. Early or late reperforation of the graft is extremely rare and late perforations due to otitis media close spontaneously since large defects are not expected. The results in respect of graft durability and hearing improvement are very satisfactory.