Introduction: In usual technique of tympanoplasty almost all of otologic surgeons use gelfoam in the middle ear for support of graft against margin of tympanic membrane perforation. In this study we use technique that we did not use gelfoam in the middle ear. We compared results of graft taking rate in two techniques. Materials and Methods: In a clinical trial study during 2 years 181 patients with COM underwent tympanoplasty with underlay grafting. In 83 patients used gelfoam in the middle ear for tympanoplasty or tympanomastoidectomy (CCTM, OCTM). In 98 patients we did not use gelfoam in the middle ear. Results: In 83 patients with use of gelfoam, graft taking rate in 59 (71.1%) cases with tympanoplasty and CCTM was 54 (91%) and in 24 (28.9%) cases with OCTM was 20 (83%). In 98 patients without use of gelfoam, graft taking rate in 61 (62.2%) cases with tympanoplasty and CCTM was 54 (89%) and in 37 (37.8%) cases with OCTM were 31 (84%). Conclusion: In this study, results of graft taking rate were similar in 2 groups. On the other hand, gelfoam entirely reabsorbed during 45 to 54 days in the middle ear and immune system react by a round cell response. This sponge encourages the formation of the fibrous tissue at a higher rate than naturally occurs in the ear. In our technique we had not these problems. Another advantage of this technique is rapid improvement of patient hearing after removing of the external ear canal rosebud. We think this technique could be used in tympanoplasty and tympanomastoidectoy routinely.