Objectives
The primary aim and an important step in chronic otitis media (COM) surgery are to repair the tympanic membrane (TM) [1] . The two most widely used graft materials in tympanoplasty are temporal fascia (TF) and cartilage graft (CG), and it is now recognized that graft performance and hearing outcomes are comparable, but CG is superior in ears with poor prognostic features [1, 2]. Tos reviewed 23 different cartilage tympanoplasty methods according to the indications in 2008 [3]. New cartilage graft designs with successful results continue to report in the literature due to the easy harvesting and application of cartilage grafts [4, 5]. Cartilage graft techniques, different designs, and indications were discussed in two comprehensive systematic review by Tos and Yung [3, 6]. Studies involving new cartilage graft techniques in the literature are mostly in the form of case-control studies or technical reports, and multiple comparative analyzes are very rare. WsCCG technique is a new modification and designed to adapt to tympanic membrane structure and avoiding retraction pockets. Successful results of the WsCCG according to the TF graft technique have been reported previously [5]. Therefore, this research aims to compare the graft success and audiological results of the most experienced and valid techniques (palisade cartilage graft: PCG and island cartilage graft: ICG) with the wheel-shaped composite cartilage graft (WsCCG) method.