Members of the Otologic Medical Group have been using a porous polyethylene prosthesis since mid-1976. Several modifications of technique have evolved, which are described. Short-term hearing results are the same as with previous techniques, but they are more stable long term. Extrusion now occurs in approximately 5% of cases, usually due to a eustachian tube problem. In general we are pleased with our results and plan to continue to use these prostheses.