A valuable aeration of the middle ear from the Eustachian tube to the aditus ad antrum is realized by the implantation of a one inch long part of the Vena saphena magna. A tube of polyethylene introduced in the ostium of the Eustachian tube maintains the vein in position during 3-4 weeks, the intima of the vein is an empeachment for synechia with the promontorium. By a special incision the deeper tissues of the ear are formed to a pediculated flap. The splitting of this flap enables the formation of a superficial thin flap, which includes the skin of the external auditory conduct. Applicated on the fascia, a consolidated and fixed neotympanon is realized, the deeper, thicker flap is filling the excavation of the bone. The cartilage of the concha is a valuable substitute of the bridge and the posterior wall of the external auditory conduct.