Sutured Patching Tympanoplasty: Our Technique and Results

Tympanic membrane perforations are typically repaired using surgical tympanoplasty techniques, which involve various grafting materials and approaches. While effective, traditional tympanoplasty methods can require significant operative time and technical skill. This study evaluates a novel sutured patching (SP) tympanoplasty technique, comparing its efficacy and outcomes to conventional tympanoplasty (CT).

This prospective study included 44 patients with small, central, dry tympanic membrane perforations.

SP utilized tragal cartilage sutured to a silastic sheet, applied via a transcanal approach. Patients were monitored postoperatively for pain, subjective hearing improvement, and audiological outcomes. Follow-up occurred at 6 days, 4 weeks, and 6 months post-surgery. Data were analyzed using t-tests , χ 2 tests, and linear regression.

Both SP and CT achieved 100% graft integrity at 6 months. Preoperative ABG was lower in the SP group (16.0 ± 10.4 dB) compared with the CT group (22.2±7.66 dB, P = 0.032), with comparable postoperative ABG values (SP: 6.90±5.80 dB; CT: 9.57±6.01 dB, P = 0.143). SP demonstrated significantly shorter operative times (27.9±8.27 vs. 87.1±25.9 min, P < 0.001) and reduced postoperative pain (VAS: 2.00 vs. 5.00, P < 0.001). Patients in the SP group reported quicker subjective hearing improvement (median: 1 vs. 24.5 d, P < 0.001).

Sutured patching tympanoplasty offers comparable audiological outcomes to conventional tympanoplasty, with the added benefits of reduced operative time, less postoperative pain, and faster perceived recovery. This technique is a promising alternative for suitable patients, particularly in resource-limited settings or high-risk surgical candidates. Further research is warranted to evaluate long-term outcomes and broader applicability.