13. The meaning and types of tympanoplasty

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Last updated 4:33 PM on 6/1/26
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4 Terms

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Define tympanoplasty

  • surgical reconstruction of tympanic membrane and/ or ossicles

  • purpose to repair TM perforation and improve hearing

2
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How is the TM reconstructed

  • by perichondrium, fascia or cartilage positione under it

3
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How are the ossciles reconstructed

  • prosthetic implants or autograft

4
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What are the classifications of tympanoplasty

  • Wullstein classification of tympanoplasties: ONLY 1 AND 3 HAVE PRACTICAL CLINICAL IMPORTANCE

    • Type 1 tympanoplasty (myringoplasty):

      • TM is grafted to an intact ossicular chain

    • Type 2 tympanoplasty:

      • Malleus is eroded

      • TM is grafted to the malleus remnant or the incus

    • Type 3 tympanoplasty:

      • Malleus and incus are absent

    • TM is grafted to the head of stapes

    • Type 4 tympanoplasty:

      • Malleus, incus and head of stapes are absent

    • Type 5 tympanoplasty:

      • The footplate of stapes is fixed by sclerosis and the rest of the ossicles are absent

    • TM is grafted to a fenestration in the lateral semicircular canal → creates a new oval window