OBJECTIVE: The success of tympanoplasty is mainly defined by the post-operative integrity of the tympanic membrane, as well as the absence of any need for further operating. Among the factors affecting the outcome, the surgical grafting technique is still a matter of debate. Our aim is to report the results of the split two-layer cartilage-perichondrium technique. METHODS: We carried out a retrospective study of 108 consecutive adult patients undergoing myringoplasty, assessing both surgical and audiological outcomes of the split two-layer cartilage-perichondrium technique, including primary and revision cases. RESULTS: Complete perforation closure was observed in 97/108 (89.7 per cent) of the cases
101/108 (93.5 per cent) had no need for further intervention. Failures were observed only in cases with total perforations without any differences between primary and revision cases. The average air-bone gap improved from 29.75 dB pre-operatively to 5.8 dB post-operatively. CONCLUSION: The results indicate high success rates of the technique with failures occurring only in total perforations.