An 8-year follow-up of Ceravital middle ear prostheses showed there was extremely good tolerance in the middle ear space. Incompatibility phenomena were not observed, and inflammatory reactions were neither caused nor supported by the implants. The tympanoplasties were always performed without interposition of cartilage between the tympanic membrane or the tympanic membrane graft and the disk-shaped portion of the implant, and extrusions were never observed. Long-lasting inflammatory processes appeared to destroy implants the same way they destroy ossicles. Transient inflammatory periods (such as episodes of purulent otitis media, which occurred soon after the prostheses were implanted) did not lead to any remarkable changes of the surface of the implant. In healthy middle ears, the hearing results were stable.