The study design consists of 600 cases of varied middle ear pathologies of safe and unsafe type. The age group was 15 to 55 and males were 54% and females were 46%. Majority cases were done under LA (480) and rest under GA (120). All routine pre op. work up was done before the surgical intervention. The results and observations were recorded for statistic. Technique of local anaesthesia: 1. The concha is pulled anteriorly and 0.5 ml of 2% xylocaine with adrenaline (1;200000) is injected in the post auricular fold. 2. The same needle is introduced subcutaneously under the posterior ear canal skin and 0.5ml local anaesthetic is injected. 3. The same needle is introduced through the same original point in the inferior direction towards inferior wall of the ear canal and 0.5 ml local anaesthetic is injected. Techniques in tympanic reconstruction: 1. Onlay technique. 2. Inlay technique. 3. Interlay technique. Onlay technique: The sliced perichondrium cartilage is placed on outer surface of the denuded drum remnant. Disadvantages: 1. Blunting. 2. Lateralization. 3. Epithelial cyst formation. Underlay Technique: The sliced perichondrium is placed underneath the drum remnant. This is most common technique in use world over. Advantages: 1. No blunting. 2. No lateralization. 3. No burying of epithelium. Disadvantages: 1. Residual perforation (Anterior, Subtotal and Total). 2. Medialization. 3. Chronic myringitis. 4. Tympanosclerosis.