Removal of head of Malleus
and body of Incus or Incus completely with dislocation of Incudo-stapedial joint and removal of scutum was done for C1b cholesteatoma (medial attic).
The MDCT images were also quantitatively analyzed by measuring the lower lateral attic recess (i.e., the distance between the long process of the incus and the lateral attic wall) and upper medial attic recess (i.e., distance between the head of malleus
and the medial attic wall) in two planes.
It was necessary to take down the posterior wall of the ear canal and remove the incus and head of malleus
to fully expose the disease.
Now epitympanic area was dissected with the help of curettage for proper visualisation of head of malleus
, body and short process of incus.