Best and Latest Treatment for Ruptured Eardrum? Tympanoplasty Options?

Hi everyone,

I’m looking for advice on treating a ruptured eardrum. Based on the size and appearance, I’d estimate the perforation covers around 60% of the eardrum.

I’m considering tympanoplasty but have some questions:
- What is considered the best and most effective treatment today for a ruptured eardrum that hasn’t healed on its own?
- Are there any newer, safer, or more advanced procedures that have become standard or are showing better outcomes?
- Is it better to use own tissue (like fascia) for the graft or something like porcine (pig skin) grafts?
- For the procedure itself, is endoscopic tympanoplasty better than the microscopic approach (which I understand may involve an incision behind the ear)?

I’d really appreciate any personal experiences, recommendations, or advice from those who’ve gone through this or know the current best practices.

Thanks so much!