Abstract
Purpose: The aim of this study was to evaluate the results of endoscopic butterfly tympanoplasty in perforations that involve the ossicular chain pathologies.
 Materials and Methods: We assessed the outcome of endoscopic modified butterfly tympanoplasty in 29 patients. The study included those with large tympanic membrane perforations covering the manubrium of malleus and has ossicular chain pathologies, operated via endoscopic transcanal tympanoplasty. 
 Results: The tympanic membrane closure rate was 89.7% (26 of 29 ears). The mean air conduction in the pre- and postoperative period was 37.75±5.20 dB and 18.96±6.52 dB, respectively, with a statistically significant decrease of 18.79±7.33. The mean pre- and the postoperative air-bone gap was 27.82±4.74 dB and 9.17±4.89 dB, respectively, with a statistically significant decrease of 18.62±7.11 
 Conclusion: The endoscopic modified butterfly tympanoplasty technique is a minimally invasive technique that can provide successful results in large perforations with defective incudostapedial joint.
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