Wullstein Tympanoplasty Classification

  • Type 1 involves repair of the tympanic membrane alone, when the middle ear is normal. A type 1 tympanoplasty is synonymous to myringoplasty.
  • Type 2 involves repair of the tympanic membrane and middle ear in spite of slight defects in the middle ear ossicles. Malleus is eroded. Tympanic membrane grafted to incus.
  • Type 3 involves removal of ossicles and epitympanum when there are large defects of the malleus and incus. The tympanic membrane is repaired and directly connected to the head of the stapes (suprastructure).
  • Type 4 describes a repair when the stapes foot plate is movable, but the crura are missing. Tympanic membrane grafted to a mobile footplate.
  • Type 5 is a repair involving a fixed stapes footplate.

References:

Wullstein H. Theory and practice of tympanoplasty. Laryngoscope. 1956;66(8):1076-93.