In middle ear surgery, hearing restoration and eradication of disease are the final goal, so ossiculoplasty is one of the most important procedure. Even though the remarkable progression of method in ossiculoplasty, the hearing restoration was not universially successful due to different ossicular defect using various material. We used cartilage, ossicle, or synthetic materials(proplast or ceravital) for ossicular defect. We doubted that hearing gain might be difference according to materials used in ossicular chain reconstruction. We had reported our result of first survey in 1985¹⁾. This study covered 441 ears received ossicular reconstruction from January, 1984 to December, 1988. We compared these results to previous study. 1) The number of ears received ossiculoplasty between grafted drum and capitulum, footplate of the stapes or oval window were 249 ears. 124 ears were followed up and mean follow up period was 10 months. 2) 63.5% of ears received ossiculoplasty between grafted drum and capitulum had a postop. air-bone gap less than 30dB but 42.6% of ears received ossiculoplasty between grafted drum and footplat or oval window. 3) 59.4% of ears received ossiculpolasty between grafted drum and capitulum using cartilage, 81.8% of those using ossicle, 60.0% of those using proplast or ceravital had postop. air-bone gap less than 30dB. 4) 32% of ears received ossiculoplasty between grafted drum and footplate of oval window 44.4% of those using ossicle, 51.5% of those using proplast or ceravital had a postop. air-bone gap less than 30dB. 5) 48.5% of ears received ossiculoplasty using autograft cartilage of ossicle, 45.8% of those using homograft cartilage of ossicle had postop. air-bone gap. 6) 46.8% of ears received ossiculoplasty had postop. air-bone gap more than 30dB. 37.1% of those cases had fail drum graft-the main cause of it was dislocation of ossiculoplaty material or lateral healing. 37.1% those cases had success drum graft but postop. air-bone gap more than 30dB-the main cause of it was infection or extrusion of material. 7) 50.7% of ears received ossiculoplasty with one stage, 57.1% of those with had postop. air-bone gap less than 30dB. 8) 46.8% of ears received ossiculoplasty with open cavity mastoidectomy, 50% of those cases with intact canal wall mastoidectomy had postop. air-bone gap less than 30dB.