In Wullstein's classification of tympanoplasty, a Type III repair (myringostapediopexy) is performed when which middle ear structure is intact?

• A Malleus handle only
• B Intact ossicular chain with normal mobility
• C Stapes head and suprastructure only (malleus and incus absent) ✓
• D Stapes footplate only (entire suprastructure absent)

Explanation

In Wullstein Type III tympanoplasty, the malleus and incus are absent but the stapes head/suprastructure is intact; the new tympanic membrane is placed directly on the stapes head (myringostapediopexy), preserving the sound transformer mechanism. Type IV is performed when only the mobile footplate remains, and Type V uses a fenestration of the horizontal semicircular canal.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.