cholesteatoma pars tensa pattern - queensland …right pars tensa cholesteatoma. keratin debris is...
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CHOLESTEATOMA
Pars Tensa Pattern
© Bruce Black MD
Severe adhesive otitis. Marked posterior pars tensa collapse, partial necrosis of the incus long process. Very early keratin accumulation on the scutum may indicate
impending cholesteatoma formation. © Bruce Black MD
Advanced Rt. Adhesive otitis. Invagination behind the lower pars tensa and incus necrosis. Early keratin debris accumulation at 9 0’clock indicates a Grade III to IV
change. © Bruce Black MD
Extensive drum invagination with overt keratin accumulation on the posterior scutum. The collapse resembles a true
drum , but the pocket lining is shiny rather than glistening. © Bruce Black MD
Subtotal drum collapse and breakdown antero-inferiorly .Probable chain pathology. Keratin accumulation postero-
superiorly. ? Early cholesteatoma. © Bruce Black MD
Stage III adhesive otitis. The incus has necrosed, and the stapes is obscured by a spherical mass of keratin, either as
a result of local infection or deeper invagination. © Bruce Black MD
Severe drum collapse, serous effusion present. Keratin accumulation over the incus and stapes with possible attic
extension. © Bruce Black MD
Localised collapse of the postero-superior pars tensa. Whilst debris is evident on the rim of the pocket, the deep
pocket appears clear. Possible early cholesteatoma. © Bruce Black MD
Localised drum retraction and debris accumulation around the rim and also in the deep pocket. Progressive pars tensa
cholesteatoma formation. © Bruce Black MD
Similar case to the previous. Keratin accumulation around and in the pocket, plus necrosis of the long process of the
incus. Stapes visible within the pocket. © Bruce Black MD
Substantial posterior drum collapse. Loss of the incus long process and stapes head. Accumulation of dry keratin emanating form the pocket. Impending cholesteatoma. © Bruce Black MD
An unusual anterior pars tensa deep retraction pocket. Prior removal of a keratin plug. Cholesteatomatous degeneration
progressing. © Bruce Black MD
Gross drum collapse, chain intact. Granulations in the hypotympanum, keratin debris in the posterior
hypotympanum and EAC. Advancing cholesteatoma. © Bruce Black MD
Subtotal drum collapse, dry keratin plug overlying the site of the probably necrosed incus and stapes. Impending
infection and active cholesteatoma formation. © Bruce Black MD
Moderate poterior drum collapse. Recent infection and keratin visible under the scutum indicate a pars tensa
cholesteatoma penetrating the attic. © Bruce Black MD
Active pars tensa cholesteatoma. Classic posterosuperior drum collapse and silvery moist semisolid keratin mass
projecting down from the attic extension. © Bruce Black MD
A large pocket is present containing moist keratin debris. The chain details are obscured but the incus and stapes
appear enveloped with squamous epithelium. © Bruce Black MD
Pars tensa cholesteatoma. Typical retraction pocket filled with silvery keratin extending superiorly into the attic.
Severely tympanosclerotic remaining pars tensa. © Bruce Black MD
Pars tensa cholesteatoma with postero-superior scutum erosion. A granulation overlies the lenticular process and
stapes. © Bruce Black MD
Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a
large perforation due to atrophy from chronic tubal failure. © Bruce Black MD
Advanced pars tensa cholesteatoma. Gross drum collapse and extensive attic invagination. Profuse keratin and
granulations are present, extruding from the attic. © Bruce Black MD
Advanced pars tensa cholesteatoma. A large infected perforation is present below the mass of silvery gold keratin
protruding from the attic. © Bruce Black MD