The first attempt of repairing a tympanic membrane was performed in 1640 whenBanzer used a pig's bladder. Wulstein and Zoellner popularisedmyringoplasty technique in 1951 and with improved optics andmicrosurgery it is still practiced in modern days.Many techniques of myringoplasty have been published in the literature.The two most widely accepted techniques for grafting in myringoplasty arethe UNDERLAY or medial grafting and the OVERLAY or lateral grafting.Causes of failure in Myringoplasty are variable and greatly depend on surgicaltechnique and surgeon experience. Eustachian Tube dysfunction is a majorfactor. Other causes include infection, size and location of the perforation.We need to standardize outcome measures. We need studies with longerfollow-up times. The solution to this problem lies in improved physician tophysician communication.