In conclusion, with the introduction of newer technology and surgical methods, the past 25 years have seen a great evolution, refinement, and improvement of tympanoplastic procedures. The original description and classification by Wullstein in the 1950s has been modified. The introduction of ossicular reconstruction with biocompatible implants greatly enhanced the success of type 3 tympanoplasty. Reasonable hearing result expectations have been well established. Newer techniques, many of which are still being developed, have minimized complication rates and infection recurrence and optimized air-bone gap closure. Future research is needed to better understand the acoustic principles that dictate success or failure in these cases.