A 25-year-old patient undergoes tympanoplasty with underlay technique. Postoperatively at 3 weeks, the graft is found to be lateralized and displaced laterally from the annulus. The most likely cause is:
- A Failure to support the graft medially with Gelfoam
- B Inadequate anterior placement of the graft under the anterior canal wall ✓
- C Postoperative infection
- D Failure to lateralize the graft
Correct answer: B. Inadequate anterior placement of the graft under the anterior canal wall
Explanation
Graft lateralization occurs when the graft is not adequately tucked under the anterior canal wall and malleus handle. The anterior tympanomeatal angle must be at least 90 degrees or the graft lacks medial support and falls laterally. Gelfoam supports the graft medially but anterior placement is the key technical factor preventing lateralization.
Reference: Glasscock-Shambaugh Surgery of the Ear, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.