Wullstein Classification of Tympanoplasty
Type I Tympanoplasty
Involves reconstruction of a new tympanic membrane in situations with a normal ossicular chain; recreates the middle ear space nearly exactly to its native size and geometry
Type II Tympanoplasty
Involves reconstruction of a new tympanic membrane in situations where the malleus is partially eroded; the new tympanic membrane is coupled with or without the malleus remnant to the native incus
Type III Tympanoplasty
Involves reconstruction of a new tympanic membrane in situations involving defects of the malleus and incus; the new tympanic membrane is coupled to the capitulum of the stapes
Type IV Tympanoplasty
Involves reconstruction of a new tympanic membrane and establishment of ossicular coupling to a mobile stapes footplate with absent crura; the new tympanic membrane is coupled to the footplate of the stapes
Type V Tympanoplasty
Involves reconstruction of a new tympanic membrane and establishment of ossicular coupling to the scala vestibuli in situations involving a fixed stapedial footplate; creation of a fenestra novovalis is necessary; this may also be termed malleovestibulopexy
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