A 30-year-old patient undergoes type III tympanoplasty with ossicular chain reconstruction. Intraoperatively, the malleus and incus are found to be eroded. The stapes suprastructure is intact. The most appropriate ossiculoplasty technique is:

• A Stapedectomy with piston insertion
• B Total ossicular replacement prosthesis (TORP) from tympanic membrane to footplate
• C Malleus to footplate prosthesis
• D Partial ossicular replacement prosthesis (PORP) from tympanic membrane to stapes head ✓

Explanation

When the stapes suprastructure is intact but the malleus and incus are eroded, a PORP is placed from the tympanic membrane/graft to the stapes head. D TORP is used when the stapes suprastructure is also absent, requiring prosthesis to reach the footplate. This corresponds to Austin classification D (malleus absent, stapes intact) and is the most common ossicular defect pattern.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.