Question: A 14 year old male is referred for a large tympanic membrane perforation and conductive hearing loss. You proceed with tympanoplasty. Intraoperatively, you discover that the stapes footplate is surrounded by a dense plaque-like material. There is no middle ear cholesteatoma. The malleus and incus are mobile. What is the most appropriate next step?

a) Abort tympanoplasty

b) Stapedectomy and medial underlay graft

c) Stapes mobilization and medial underlay graft

d) Complete tympanoplasty followed by stapedectomy after drum has healed

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

Answer to last week's question, “You Spin Me Round” (March 15, 2021)

C - Persistent postural perceptual dizziness