Radiological signs indicating cholesteatoma in the attic included erosion or destruction of scutum or spur (the lateral wall of the attic), widening of the aditus ad antrum
(loss of figure of "8" appearance) , antral wall erosions and widening , ossicular erosions and destruction , medial attic wall erosion which may lead to facial nerve canal involvement, which may cause paresis or paralysis , erosion of the lateral semicircular canal which may result into fistula formation (Figure 1), dehiscence of tegmen tympani , dehiscence of sigmoid sinus plate, erosion of the external auditory canal (EAC), and automastoidectomy.
These changes when associated with bony expansion of the middle ear cavity and aditus ad antrum
are highly suggestive of cholesteatoma [1, 5, 7, 8]
They could identify several key structures such as incudomalleolar articulation, tympanic segment of the facial nerve, lateral semicircular canal and aditus ad antrum
, all without provoking lesions in the middle ear structures.
A soft, grayish, well-demarcated mass filled the mastoid antrum, mastoid tip, aditus ad antrum
, and epitympanum.
However, imaging studies have shown that all compartments of the middle ear cleft are uniformly involved as a "field infection." Therefore, the drug likely distributes, except in rare exceptions such as a blocked aditus ad antrum