Inlay cartilage myringoplasty has gained consensus by many surgeons for the repair of tympanic membrane erforations through a transcanal approach. 4 It provides several practical advantages, for example, no support through external auditory canal packing or middle ear is required as the graft has good stability. Postoperatively patient comfort is enhanced, and the operation has less expenditure because of contracted operative and recovery time. 5 Periosteum of the mastoid cortex has been described in the literature as a suitable grafting material for tympanic membrane repair, with several advantages. 6 However, there are few clinical trials comparing both types of grafts. Material and methods This study was retrospective controlled trial, comparing two different techniques performed by two university hospitals, in the period from 2014 to 2016. One hundred fourty nine patients were involved in this study. Patients were classified into two groups: Group A Included 88 patients underwent underlay periosteal TM grafting performed in a university hospital. Group B Included 61 patients subjected to inlay cartilage tympanoplasty in another university hospital. All patients had dry central TM perforation for at least 2 months before surgery. Cases with granulations, discharge, myringitis, active infection, otomycosis, mixed hearing loss, previous failed myringoplasty, and cases which required cortical mastoidectomy, middle ear exploration were excluded. Preoperative history taking and audiological assessment were done by calculating Air Bone Gap (ABG) as the average hearing level at 500, 1000, 2000 and 4000 Hz frequencies. Intraoperatively the time consumed during the operation was recorded in minutes. Postoperative evaluation was done 6 months post surgery included: graft take and mean ABG. Statistical methods Data were coded and entered using the statistical package Statistical Package for the Social Sciences (SPSS) version 25. Data was
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