cholesteatoma pars tensa pattern - queensland …right pars tensa cholesteatoma. keratin debris is...
TRANSCRIPT
![Page 1: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/1.jpg)
CHOLESTEATOMA
Pars Tensa Pattern
© Bruce Black MD
![Page 2: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/2.jpg)
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
![Page 3: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/3.jpg)
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
![Page 4: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/4.jpg)
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
![Page 5: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/5.jpg)
Subtotal drum collapse and breakdown antero-inferiorly .Probable chain pathology. Keratin accumulation postero-
superiorly. ? Early cholesteatoma. © Bruce Black MD
![Page 6: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/6.jpg)
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
![Page 7: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/7.jpg)
Severe drum collapse, serous effusion present. Keratin accumulation over the incus and stapes with possible attic
extension. © Bruce Black MD
![Page 8: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/8.jpg)
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
![Page 9: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/9.jpg)
Localised drum retraction and debris accumulation around the rim and also in the deep pocket. Progressive pars tensa
cholesteatoma formation. © Bruce Black MD
![Page 10: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/10.jpg)
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
![Page 11: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/11.jpg)
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
![Page 12: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/12.jpg)
An unusual anterior pars tensa deep retraction pocket. Prior removal of a keratin plug. Cholesteatomatous degeneration
progressing. © Bruce Black MD
![Page 13: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/13.jpg)
Gross drum collapse, chain intact. Granulations in the hypotympanum, keratin debris in the posterior
hypotympanum and EAC. Advancing cholesteatoma. © Bruce Black MD
![Page 14: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/14.jpg)
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
![Page 15: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/15.jpg)
Moderate poterior drum collapse. Recent infection and keratin visible under the scutum indicate a pars tensa
cholesteatoma penetrating the attic. © Bruce Black MD
![Page 16: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/16.jpg)
Active pars tensa cholesteatoma. Classic posterosuperior drum collapse and silvery moist semisolid keratin mass
projecting down from the attic extension. © Bruce Black MD
![Page 17: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/17.jpg)
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
![Page 18: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/18.jpg)
Pars tensa cholesteatoma. Typical retraction pocket filled with silvery keratin extending superiorly into the attic.
Severely tympanosclerotic remaining pars tensa. © Bruce Black MD
![Page 19: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/19.jpg)
Pars tensa cholesteatoma with postero-superior scutum erosion. A granulation overlies the lenticular process and
stapes. © Bruce Black MD
![Page 20: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/20.jpg)
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
![Page 21: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/21.jpg)
Advanced pars tensa cholesteatoma. Gross drum collapse and extensive attic invagination. Profuse keratin and
granulations are present, extruding from the attic. © Bruce Black MD
![Page 22: CHOLESTEATOMA Pars Tensa Pattern - Queensland …Right pars tensa cholesteatoma. Keratin debris is evident in the postero-superior invagination. The lower drum has a](https://reader031.vdocuments.us/reader031/viewer/2022022003/5aa136ef7f8b9a84398b5f0d/html5/thumbnails/22.jpg)
Advanced pars tensa cholesteatoma. A large infected perforation is present below the mass of silvery gold keratin
protruding from the attic. © Bruce Black MD