We would like to thank, Dr Satvinder Singh Bakshi for valuable comments on our article.

First of all in pediatric tympanoplasties both fascia and cartilage grafts were used. The patients were divided into two groups according to the graft material. Cartilage graft was preferred for the revision cases and for the patients who had tympanosclerosis and in the other ones fascia graft was used.

In our study group we did not evaluated bilateral perforations.

In the cartilage group the tragal cartilage was used. The cartilage was harvested and whole piece was used without thinning. The pericondrium of the cartilage at the convex side was peeled and an island graft was prepared. A cartilage strip 2 mm in width was removed at the middle portion of the cartilage, to fit the cartilage graft to the manibrium of the malleus. The composite condropericondrial island graft was placed with over-underlay technique over the malleus under the drum remnant under the annulus described by Kartush et al .