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There is no need to cover cartilage with fascia or skin. A "cartilage palisade tympanoplasty" (Fig 6) may be partly covered with replaced epithelium from the deepithelisation of the drum remnant. Even with no epithelium remnants, the defect is covered after some weeks with a fine layer of epithelium from the endaural canal skin.The same holds true for the "cartilage bridge" from the stapes to the lower annulus (Fig 7, 8, and 10) and the cartilage "tunnel plasty" at the eustachian tube entrance. The space between the "cartilage bridge" and the endaural canal wall (bony annulus) is, in point of fact, closed by us. We refer to page 237. In young patients we use segments of fascia. Cartilage wedges are employed in cases of tympanosclerosis, diabetes, thin endaural canal skin, and in patients more than 40 or 50 years of age.Finally the "antrumplasty" and the "mastoidplasty" need