This document compares tympanoplasty (ear drum repair surgery) done with or without removing the skin of the posterior ear canal wall. Both techniques were performed on dry ear cases using an underlay grafting method with temporalis fascia. Results found no significant differences between the groups in terms of graft uptake rate (success rate over 90% in both), post-operative granulation rates, or average air-bone gap closure. While removing the posterior canal wall skin provided better surgical exposure, preserving the skin did not negatively impact outcomes when using proper surgical techniques. The conclusion is that removing or preserving the posterior canal wall skin during tympanoplasty does not alter results as long as an appropriate surgical method is used.