Underlay technique over the handle of Malleus

in concordance with Zolner-Wullstein classification of Tympanoplasty, in Type I Myringoplasty, graft is placed in either Overlay/Underlay technique over the handle of Malleus,

Always remember the position of graft in both overlay and underlay is always in respect of annulus or fibrous layer of tympanic membrane and not in accordance to malleus as in both technique the graft is tucked in handle of malleus i.e medial to it.

Thus for overlay correct position is lateral to the fibrous or second layer of tympanic membrane

And in underlay it is medial to annulus

Much appreciated, thanks Dr. Phulkit Rode and Dr. Sayan Paul for connecting with me.