What is the mechanism for foreshortened handle of malleus?

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Kartik Parelkar

Thank you so much for the info sir.

Ramesh Parajuli

In case of perforated TM, this could be due to the(unopposed) action of tensor tympani muscle

But then we do see foreshortening in patients with intact TM too,how do we explain that?

How do you ll place the underlay graft in cases of foreshortened handle of malleus touching the promontory ?

The tip of the handle of malleus (touching the promontory) has to be cut and the graft can be placed medial to it(remnant).

Wouldnt that affect our hearing results ?