We reviewed 1042 operations in which a Plasti-Pore prosthesis was used for reconstruction of the sound pressure transfer mechanism. In all cases cartilage was interposed between the prosthesis and the tympanic membrane or graft. The short-term hearing results for these cases are the same as for other techniques but the hearing is more stable in the long run. Other advantages of this technique are a reduced incidence of recurrent and residual cholesteatoma. Extrusion occurred in 7% of the cases but has become less frequent with recent refinements in technique. We intend to continue using Plasti-Pore prostheses in tympanoplasty.