Tympanoplasty is a common otologic procedure used to repair tympanic membrane perforations, treat chronic infections, and restore conductive hearing loss. Middle ear packing (MEP) materials are frequently used postoperatively to stabilize grafts, prevent adhesions, and support hemostasis; however, the optimal choice of packing material remains debated. Chitosan-based materials represent a novel alternative to traditional options, including gelatin sponge.
This retrospective review identified 27 patients who received chitosan-based middle ear packing between 2017 and 2021 and compared postoperative outcomes with historical controls who received gelatin sponge. Demographic data, surgical details, and postoperative outcomes were abstracted. Audiometric evaluations were reviewed to assess changes in conductive hearing loss.
Outcomes demonstrated similar rates of graft failure and postoperative infection between the chitosan and gelatin sponge groups. No evidence of ototoxicity was observed in the chitosan cohort. Audiometric analysis showed average bone PTA changes of 1 dB, with 30–40% of patients achieving closure of the air–bone gap greater than 10 dB.
These findings support chitosan as a safe and effective middle ear packing material in tympanoplasty, performing comparably to gelatin sponge. Further research with larger sample sizes and longer follow-up intervals is warranted to assess long-term rates of scarring, fibrosis, and postoperative middle ear outcomes.