Endoscopic Butterfly Myringoplasty: Comparison of Tragal Cartilage Graft and Dermal Allograft

ABSTRACT Objectives Tympanic membrane perforation (TMP) is a common reason for visits to otolaryngology clinics. For decades, various surgical methods and grafts have been employed to treat TMP. This study aimed to compare the efficacy of tragal cartilage grafts (TCG) and dermal allografts (DAG) in myringoplasty for treating TMP. Methods We retrospectively analyzed 80 patients who underwent endoscopic butterfly inlay myringoplasty between 2019 and 2022. The patients were divided into two groups based on the graft material used: TCG ( n  = 40) and DAG ( n  = 40). We compared preoperative and postoperative hearing results and surgical outcomes between the two groups. Results Both the TCG and DAG groups demonstrated significant postoperative improvements in hearing. The air‐bone gap decreased from 11.87 to 7.74 dB in the TCG group ( p  = 0.01) and from 13.6 to 8.96 dB in the DAG group ( p  = 0.013). Similarly, the low‐tone average improved significantly: from 40.49 to 25.26 dB in the TCG group ( p  < 0.001) and from 38.33 to 25.15 dB in the DAG group ( p  < 0.001). The graft closure rates were comparable at 97.5% for TCG and 92.5% for DAG, indicating that both procedures are effective and similar in efficacy. However, the TCG group required more follow‐up visits (average of 4 vs. 2.6 for DAG). Conclusions Both TCG and DAG techniques demonstrated comparable efficacy in terms of graft success rates and hearing improvement, with no significant differences in postoperative complications. Level of Evidence 3