Clean-cut Classifications

Question 1

Types of Tympanoplasty (Wullstein)

Answer 1

Wullstein Classification

“MISh! move your foot or fix it”
(TM on malleus, incus, stapes head, stapes footplate (movable, stapes footplate fixed)

Type I: repair of the TM alone; no abnormality of the middle ear. Type I tympanoplasty is synonymous with myringoplasty.

Type II: repair of the TM and middle ear; the malleus is eroded. Tympanoplasty involves grafting the TM to the incus.

Type III: repair of the TM onto the stapes head; the malleus and incus have a defect

Type IV: the TM is grafted to the stapes footplate, which is movable

Type V: repair involves the stapes footplate, which is fixed.

Question 2

Types of Tympanoplasty (Tos)

Answer 2

Tos Classification

Type I: myringoplasty

Type II: ossiculoplasty with short columella
(stapes capitulum intact)

Type III: ossiculoplasty with long columella
(only stapes footplate intact)

Type IV: placement of graft over footplate with creation of cavum minor

Type VA: creation of fenestra over LSCC
(no ossicles, fixed footplate, functional round window)

Type VB: removal of fixed footplate
(no ossicles, fixed footplate)

Question 3

Fitzpatrick

Answer 3

I
Pale white skin, blue/green eyes, blond/red hair
Always burns, does not tan

II
Fair skin, blue eyes
Burns easily, tans poorly

III
Darker white skin
Tans after initial burn

IV
Light brown skin
Burns minimally, tans easily

V
Brown skin
Rarely burns, tans darkly easily

VI
Dark brown or black skin
Never burns, always tans darkly

Question 4

Glogau photoaging scale

Answer 4

I - Mild
age 28-35 No wrinkles
Early Photoaging: mild pigment changes, no keratosis, minimal wrinkles, minimal or no makeup

II - Moderate
age 35-50 Wrinkles in motion
Early to Moderate Photoaging: Early brown spots visible, keratosis palpable but not visible, parallel smile lines begin to appear, wears some foundation

III - Advanced
age 50-65 Wrinkles at rest
Advanced Photoaging: Obvious discolorations, visible capillaries (telangiectasias), visible keratosis, wears heavier foundation always

IV - Severe
age 60-75 Only wrinkles
Severe Photoaging: Yellow-gray skin color, prior skin malignancies, wrinkles throughout—no normal skin, cannot wear makeup because it cakes and cracks

Question 5

Classification of Laryngeal Trauma (Eponym) and levels

Answer 5

SCHAEFER CLASSIFICATION

Level I
minor hematoma / lacerations
no fracures

Level II
mod edema, mucosal breaks with exposed cartilage
(+) fx but undisplaced

Level III
VF immobile, massive edema
(+) fx, displaced

Level IV
>2 displaced fx
anterior commisure involvement
massive edema

Question 6

Classification system for SUBGLOTTIC stenosis (eponym)

Answer 6

MYER-COTTON CLASSIFCATION
(circumferential stenosis)

Grade I - 0-50% obstruction of lumen
Grade II - 51-70%
Grade III - 71-99%
Grade IV - 100%

Question 7

Classification system for LARYNGEAL stenosis

Answer 7

Grade I - <70%
Grade II - 70-90%
Grade III - >90% with identifiable lumen
Grade IV - no identifiable lumen

Question 8

Failure of fusion of posterior cricoid lamina & Classification system (eponym)

Answer 8

LARYNGEAL / LTE CLEFTS

BENJAMIN-INGLIS CLASSIFICATION

Type I - interarytenoid cleft (above VF)

Type II - partial cricoid cleft, remains above the cricoid lamina

Type III - complete cricoid cleft, with or without extension into the cervical cartilage

Type IV - laryngoesophageal cleft, extending into the thoracic trachea, may extend as far as carina

EVANS CLASSIFICATION
type 1 same
BA type 2&3 = 2
BA type 4 = type 3