Background: Tubotympanic type of chronic suppurative otitis media is one of the most frequent diseases seen in ENT clinics. On examination, central perforation in the tympanic membrane can be seen. Different approaches were used for closure of tympanic membrane perforations mainly the postauricular, the end aural and trans canal.
Objective: To compare between endoscopic and microscopic trans canal myringoplasty using tragal cartilage graft regarding success rate and postoperative hearing improvement.  Patients and Methods: This prospective study was carried out on 24 patients from December 2017 till August 2018. All patients were presented with small or medium sized central perforation which was dry for at least 3 months, and then subjected to preoperative clinical, endoscopic, audiological assessment. Patients were divided equally and randomly into two groups, group A for endoscopic myringoplasty and group B for microscopic myringoplasty, composite cartilage-perichondrium graft was used for both groups and all of them were arranged to postoperative re-evaluation after 1, 2, 4 and 12 weeks.
Results: The mean age group of our studied patients was 31.5 ± 7 years. (45.8 %) of patients were male, while (54.2 %) of them were female. Graft uptake in endoscopic myringoplasty was 100 % while in microscopic was 83 % of cases. Postoperative air bone gap was less than 10 dB in 100 % of the patients in endoscopic group and 66.67 % in microscopic group.  Conclusion: Although these results were statistically insignificant, advantages of endoscopic myringoplasty overcomes most of the disadvantage of microscope.