Of 686 patients who underwent tympanoplasty, 45 had nonotosclerotic bony fixation of the ossicular chain (malleus, 17; incus, 10; stapes, 4; malleus and incus, 11; all ossicles, 1). Two patients had bony fixation of autografts. The incus and malleus may be fixed in various sites in the epitympanum. The most common causes were cholesteatoma and sequelae of otitis, in particular, of mastoidectomy. Bony fixation was also found as a mild solitary congenital anomaly, in atresia of the auditory meatus, traumatic ossicular dislocation due to fracture of the petrous portion of the temporal bone, tympanosclerosis, chronic adhesive otitis media, and chronic granulating otitis.