A research project concerning performed autologous ossicles has been going on for more than ten years. Animal experimental studies were followed by a clinical pilot study which showed that bone could be produced in a titanium mould placed in the proximal tibia metaphysis. In the present investigation, in which another five patients were operated on, the experimental design was changed compared to the first pilot study and bone production was improved. In addition to the tibial moulds ten titanium cylinders were placed around a bony bridge prepared in the linea temporalis of the ear to be reconstructed. Nine out of ten of these cylinders contained bone suitable for ossiculoplasty. Histology showed higher osteocyte density and a higher proportion of vital looking osteocytes in the performed grafts compared with a peroperatively sculptured graft of cortical bone. On histochemical investigation the performed graft cells seemed viable at the time of transplantation. The technique for obtaining a preformed autologous ossicle through the titanium cylinders in the temporal bone was easy to perform and the patients did not experience any discomfort. The risk of infection in this area was judged to be small.