Seventy-four patients undergoing bone pate repair of the long process of the incus as part of a tympanoplasty are presented. Mean follow-up time was 66 months (range 12–143 months). Hearing results are averaged over the frequencies 500, 1000, 2000 and 4000 Hz. Thirty-two per cent of the patients had hearing thresholds better than 30 dB pre-operatively. A significant improvement in hearing was seen (p<O.OO1). The data were also analysed to assess the effect of the pre-operative state of the tympanic membrane on the final result. The pre-operative condition of the tympanic membrane was either perforated (35 ears) or atrophic (33 ears). Six tympanic membranes were intact but these were excluded from the final results. No difference in hearing result was found between patients who had an ossicular repair in combination with either a perforated tympanic membrane repair or an atrophic membrane repair. Average hearing gain in the perforated group was 13 dB, in the atrophic group 9 dB and in the intact group 7 dB.