
The study evaluated the efficacy of fat graft myringoplasty with hyaluronic acid compared to cartilage-perichondrium composite myringoplasty (CPCM) in closing large eardrum perforations. Conducted in tertiary institutions, 100 patients with perforations covering 50%–75% of the eardrum were randomized to receive either fat graft myringoplasty with hyaluronic acid (Group A) or CPCM (Group B). Fat graft myringoplasty was faster to perform, achieving a 92% closure rate at one year, slightly higher than the 86% in the CPCM group. The audiological assessment showed successful air-bone gap closure to under 10 dB in 93.5% of Group A and 81.4% of Group B, with a significant reduction in the mean postoperative air-bone gap in Group A. This approach provides a reliable and effective alternative to traditional myringoplasty methods for large eardrum perforations.
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