Sutured Cartilage Graft for Middle Ear Prosthesis Stabilization: A Case Report

Prosthesis extrusion following ossicular chain reconstruction remains a common complication with a variable reported incidence. Interposition cartilage grafts are commonly used to minimize this risk, yet displacement still occurs. We describe a novel surgical technique in which a tragal cartilage graft is sutured directly to the prosthesis before placement, aiming to improve stability and reduce extrusion risk. A 37-year-old female with chronic otitis media and tympanic membrane retraction underwent ossiculoplasty. A partial ossicular replacement prosthesis was used. Prior to implantation, an autologous tragal cartilage graft was anchored to the prosthesis using two 9-0 nylon sutures in mirror configuration. The assembly was then positioned in the middle ear through an endoscopic transcanal approach. Follow-up at one week and one month demonstrated no evidence of extrusion, displacement, or complications. This technique offers a simple, low-cost, and effective modification to conventional ossiculoplasty. Suturing the cartilage graft to the prosthesis may enhance mechanical stability. Further studies are needed to evaluate long-term outcomes.