BACKGROUND:This study was done to compare the efficacy of overlay and underlay techniques of tympanoplastyon the perforated tympanic membrane with the help of endoscope.

MATERIALS AND METHODS: This randomised prospective study was conducted in Malda Medical College and Hospital during September 2014 to September 2017. In this study 32 patients of chronic otitis media with dry central perforation for at–least 3 weeks were selected in two group of 16 each, one undergone overlay tympanoplasty and another overlay tympanoplasty by endoscope. The data was collected from above patients and statistically analysed regarding graft taken or rejected and hearing improvement.

RESULTS: Success rate regarding the drum closure in underlay  technique is 75%, where overlay  technique was 93.75%. Post–operative AIR BONE gap improvement also little better in overlay technique than underlay technique. In underlay technique one patients having medialisation of graft and in overlay technique one case of anterior blunting and another single case of lateralisation of graft.

CONCLUSION:Endoscopic overlay technique is better for closure of perforated tympanic membrane than endoscopic underlay technique but the limitation of this study was the small sample size.