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Bone 2, perforation

This dry large central perforation requires repair. Successful surgery could restore the patient’s hearing and also allow the patient to swim without getting a painful discharging ear.
Myringoplasty can be done on a Pettigrew Bone by freshening the edges of the perforation, making a myringotomy anterior to the perforation, raising a tympanomeatal flap, inserting a graft medial to the flap and the perforation rim. The anterior tip of the graft is then pulled through the previously made myringotomy in order to anchor the flap directly medial to the perforation rim.
Prior to insertion of the graft you would check the integrity and mobility of the ossicular chain.
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