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The effects of graft thickness on tympanoplasty is uncertain. To compare the results of endoscopic tympanoplasty using different thicknesses of autologous tissues. This retrospective analysis included 186 patients who received type I tympanoplasty, divided into three main groups based of grafting material: perichondrium (A), cartilage–perichondrium (B), or cartilage–perichondrium plus additional perichondrium (C). Group A was subdivided based on whether the placement was inside (A1) or outside (A2) of the malleus. The hearing improvement, graft success rate, and surgery duration were analysed. Statistical analysis showed significant hearing improvement in the three main groups ( p  &lt; .001); recovery in group A occurred the earliest. Six months postoperatively, group A1 showed significantly greater hearing recovery compared with groups B and C ( p  &lt; .05). There were no statistical differences the other groups ( p  &gt; .05) or in the graft success rate among the three main groups ( p  = .235). The surgery duration of group A was significantly longer than that of groups B and C ( p  &lt; .001). Our results suggest that graft thickness affects hearing recovery; however, graft thickness does not affect the rate of grafting success. Endoscopic transplantation of the perichondrium is more difficult and requires more time.

Endoscopic type 1 tympanoplasty: comparison of the effects of three different thicknesses grafts