Today, trauma of the head is a devastating injury to which we are all susceptible. When the head is severly injured, the ear is the most frequently damaged sensory organ. After first discovery of ossicular chain injury from skull fracture in 1956 by Thorburn¹⁷⁾ and the marvellous study of Hough and Stuart⁸⁾ about middle ear injuries in head trauma in 1968, it is now realized that these injuries occur quite frequently. The surgical microscope and the application of exploratory tympanotomy provided the basis for discovery of multiple conductive lesions previously considered unknown or extremely rare. During the past 10 years, we have encountered 30 cases of traumatic ossicular disruption which were confirmed with surgical exploration. All of these had a conductive loss of hearing sufficient to justify a surgical exploration. The most common cause of the head trauma was traffic accident (60%) and the most common pathology encountered in the middle ear was incudostapedial joint separation (80%). The male to female ratio was 2 : 1, most common in those aged in their twenties. Typical symptoms were hearing loss, tinnitus, and bleeding from the ear. The most commonly used method of hearing restoration was type 3 tympanoplasty including short columellization with the autologous incus or cartilage (30%). In 53% of the cases, hearing was restored to within 10 dB of preoperative bone conduction in the three speech frequencies (500 Hz, 1,000 Hz, 2,000 Hz).