Abstract
The evolution of tympanic membrane grafting over the past 20 years has been based on biologic tissues of mesodermal origin which contain a collagen matrix. The dominant theme of this evolution has been the modification of these collagen membranes by physical and chemical agents to achieve a more ideal graft. The graft material and the operation should be suited to specific problems. Current operative techniques and graft materials are discussed. It is believed that there will be continued modification and manipulation of collagen in the future to achieve a more ideal graft for tympanic membrane restoration.