This retrospective study looked at patients with an intact tympanic membrane with non-inflammatory causes – i.e. otitis media and cholesteotoma. They document their findings based on exploratory tympanotomy. They operated depending on the findings with either a stapedectomy or a variety of ossicular replacement procedures. The patients were subdivided into traumatic and non-traumatic. While otosclerosis figured heavily in the non-trauma group, ossicular discontinuity was the main finding in the trauma group. Obviously the postoperative hearing improvement results were excellent in the otosclerosis group, however the most interesting and encouraging finding was the improvement in the trauma group with mainly ossicular discontinuity. Food for thought perhaps in terms of exploring these.