목적: To evaluate and compare the success rates, complication profiles, operation duration, and tympanic flap engraftment in endoscopic transcanal tympanoplasty (ETT) and microscopic-assisted postauricular tympanoplasty (MPT) for large or subtotal tympanic membrane perforations. 방법:A retrospective analysis was conducted on 200 patients with large or subtotal tympanic membrane perforations. Patients were divided into two equal groups (n=100): Group 1: Endoscopic Transcanal Tympanoplasty (ETT) Group 2: Microscopic-Assisted Postauricular Tympanoplasty (MPT) Outcome measures included: Tympanic membrane closure rate Incidence of postoperative complications Mean operative time Tympanic flap engraftment rate Statistical analysis was performed to compare the results between the groups. 결과:The success rate of tympanic membrane closure in the ETT group was 96.2%, compared to 85.6% in the MPT group. The ETT group had a significantly shorter operative time. Postoperative complications, such as pain and infection, were lower in the ETT group. Tympanic flap engraftment rates were higher in the ETT group, indicating better tissue integration and healing. 결론:Endoscopic transcanal tympanoplasty demonstrates higher success rates, shorter operative times, and fewer complications compared to microscopic-assisted tympanoplasty in patients with large or subtotal tympanic membrane perforations. These findings support the adoption of endoscopic techniques as a preferred approach in suitable cases.