* Subsites: (a) Mesotympanum
, (b) Protympanum, (c) Hypotympanum, (d) Retrotympanum, (e) Antrum and (f) Mastoid.
(9,17) For smaller tumors limited to the mesotympanum
, a transcanal microscopic procedure has traditionally been employed.
(2011) SAC classification Initial location of cholesteatoma Pars flaccida cholesteatoma (attic or Prussak's space) Epitympanum (lateral to ossicle) Cholesteatoma with pars tensa type perforation (sinus) Mesotympanum
(medial to ossicle) Ad hoc group (mural cholesteatoma/auto-atticotomy) Undefined Total SAC classification Number of ears (%) Pars flaccida cholesteatoma (attic or Prussak's space) 36 (48.0%) Cholesteatoma with pars tensa type perforation (sinus) 24 (32.0%) Ad hoc group (mural cholesteatoma/auto-atticotomy) 15 (20.0%) Total 75 SAC, secondary acquired cholesteatoma Table 2.
During surgeries, localization and dimensions of cholesteatoma and the conditions of the mesotympanum
mucosa and ossicles were recorded.
Tubotympanic chronic otitis media tends to be typified by disease of the pars tensa and mesotympanum
, whereas atticoantral disease primarily involves the pars flaccida and epitympanum .
The disease was extensive with a destruction of the EAC circumferentially, exposing facial nerve, bowing of pars tensa touching the medial wall of the mesotympanum
A middle ear high-resolution computerized tomography (HRCT) scan that was requested for confirmation revealed a hyperdense homogeneic mass of calcic tonality and bone density (1265 Hounsfield units) in the right middle ear at the level of the upper mesotympanum
Total opacification of the left-sided hypo- and mesotympanum
by a soft tissue density.
Intraoperatively, a tumor was found to occupy the entire epitympanum and mesotympanum
with extension into the hypotympanum.
In early stages, it was used to provide information regarding pathology in the epitympanum, mesotympanum
and mastoid antrum and to check the assessment of ossicular chain mobility.
Although data on the prevalence of cholesteatoma are unknown, the squamous COM in the West is presumably of limited extent, confined within the attic, mesotympanum
, or the aditus.
Caption: FIGURE 4: High-resolution MDCT from 2010 (coronal and axial views): nodular tissue mass located in the mesotympanum
covering the incus and the stapes without osteolysis, suspected of tumor recurrence.