I presume the technique of quilt-plasty is already well known, Experience has shown that preserving the anterior tympanomeatal angle with the quilt-plasty leads to a better fixation and thus a better vascular supply. The success rate could be improved spontaneously both anatomically and audiologically. We use this method especially for subtotal and total defects in spite of the risk of a secondary perforation developing during the healing process. These tend to be much smaller than the primary perforations and may be dealt with in outpatients by a revision operation. 2195 ear operations were performed in three years, 1204 were tympanoplasties. 18 secondary perforations were seen with the quilt-plasties. They either healed spontaneously or were finally closed with a small operative revision in ambulant patients, The quilt-plasty is thus our method of choice.