Question: An 8 year old boy undergoes tympanoplasty for a PE-tube related tympanic membrane perforation. While lifting the tympanomeatal flap, the round knife inadvertently slides medially into the middle ear. The incudostapedial joint appears obtuse, the incus feels hypermobile on palpation, and clear fluid begins to fill the middle ear. Close inspection reveals the stapes footplate to be depressed into the vestibule. What is the next best step in management?

a) Leave the stapes where it is and close

b) Place gelfoam around the footplate to prevent further perilymph leakage

c) Remove the stapes, place perichondrium on the oval window, and place a stapes prosthesis

d) Reposition the stapes in the oval window and administer IV steroids

[Answer will be posted with next week's new question]

Answer to last week's question, “Zoom Out” (May 11, 2020)

C - Chin.