A patient has a large anterior tympanic membrane perforation with minimal residual anterior drum. The surgeon chooses the overlay technique for grafting. What is the principal disadvantage of this technique?
- A High rate of medial graft displacement
- B Blunting of the anterior sulcus with lateralization of the graft ✓
- C Injury to the chorda tympani nerve
- D Obliteration of the epitympanum
Correct answer: B. Blunting of the anterior sulcus with lateralization of the graft
Explanation
In the overlay technique the graft rests on the outer surface of the residual drum after removing canal epithelium. Failure to replace squamous epithelium exactly at the annulus causes blunting of the anterior meatal sulcus, and inadequate fixation allows lateralization away from the malleus, both producing conductive loss. Medial displacement is the concern of underlay grafting, not overlay.
Reference: Scott-Brown's Essential Otorhinolaryngology, 3rd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.