الفهرس 
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Abstract
Chronic suppurative otitis media is a major problem especially in developing countries, characterized by presence of tympanic membrane perforation, impaired hearing and recurrent ear discharge.
Myringoplasty is the surgery by which we can reconstruct the tympanic membrane perforation using different types of grafts:
1- Homogenous graft: temporalis graft, perichondrium graft, cartilage graft, fat graft, skin graft and vein graft.
2- Heterogenous graft.
3- Chemical graft.
Success of myringoplasty depends on some factors such as size of tympanic membrane perforation, material of the graft used and postoperative follow up. Myringoplasty is more successful in small central perforation than large incomplete perforation.
Temporalis muscle fascia is still the first choice for many surgeons allaround the world. Many studies have shown better graft acceptance rates using cartilage than using the temporalis fascia.
The use of cartilage in tympanoplasty is very common nowadays, because it is rigid, stable, durable and has low metabolic rate, so it is more reliable in cases of Eustachian tube dysfunction, total and subtotal TM perforation with good hearing outcomes.
Cartilage taken from auricle of ear and tragus can be used in myringoplasty by various techniques such as Butterfly cartilage technique, Palisade cartilage technique,Perichondrium-cartilage Island flap andCartilage shield technique.
This study was conducted in the department of Ear, Nose and throat at Beni-Suef University during 2018-2021. This study included 40 ears of 40 patients, divided into two groups. All had small to medium sizedtympanic membrane perforations of the safe type.
group A:20 patients underwent transcanalbutterfly cartilage tympanoplasty with graft uptake rate (95%) and ABG improvement by (8.75) dB.
group B:20 patients underwent transcanalpalisade cartilage tympanoplasty with graft uptake rate (90%) and ABG improvement by (8.15) dB.
There is improvement in healing and hearing with butterfly cartilage technique and palisade cartilage technique with no statistically significant difference between both techniques.
from the previous results we conclude that:
1- Cartilage is reliable material for reconstruction of the tympanic membrane.
2- Transcanal tympanoplasty is a simple, time saving, and minimal invasive surgery.
3- Although there is no statistically significant difference with palisade technique, butterfly technique is an excellent procedure for repairing smalltomediumsized tympanic membrane perforations.