Comparison of Topical Use of Platelet-rich Plasma Versus Hyaluronic Acid During Endoscopic Fat Graft Myringoplasty: a Randomized Clinical Study

Inclusion Criteria: * Patients with central small or median sized dry perforation * Aged between 14 and 50 years * In cases of CSOM the perforation must be dry with no otorrhea with healthy middle ear mucosa for at least three month without medications * Conductive gap on audiometry not more than 40 dB. Exclusion Criteria: * Discharging CSOM . * Concurrent URTI . * CSOM with dry marginal perforation * Patients who didn't come for follow up. * Age less than 14 or more than 50. * Unsafe CSOM with cholesteatoma, apparent retraction pockets, granulations, or extensive myringosclerosis reaching the edges of the perforation. Patients * Patients who are suspected of having Eustachian tube dysfunction. * Suspected ossicular pathology in safe CSOM if the ABG \> 40dB. * Patients with history of Previous ear surgery. * Patients unfit for surgery or having chronic medical illness. * Narrow external auditory canal. * Patients who refused to enrolled in our study * Patients with sensorineural hearing loss or only functioning ear.