Abstract: This paper was based on 5 cases (5 ears)of chronic purrullent otitismedia and mastoiditis.All these cases were treated by tympanoplastythrough a combined approach with some modification.3 years' follow-upshowed good results in 4 cases.Audiometrical improvement wasachieved in 4 cases with a maximum of 27 dB.One case failed as a resulfof reperforation of the new drum due to infection.The cause of thefailure was briefly reviewed.The authors concluded that strict selectionof the patients and good technique are the key to success.What is more,the use of double irrigation tubes after operation is beneficial to thehealing of operative wound.In one word,this method is worthyof application in otosurgery.