There has been significant bone erosion of the ear canal wall above the eardrum.
Cholesteatoma attic retraction.
Often there is an accumulation of squamous debris within the pocket figure 6a b.
Primary acquired cholesteatoma or retraction cholesteatoma this form of cholesteatoma is due to a ventilation malfunction in the middle ear often caused by insufficient tube permeability.
Granulation tissue may arise from the mucosa adjacent to the cholesteatoma figure 6c.
Eustachian tube theory.
The tube is a conduit between the middle ear and the nasopharyngeal space.
A recurrent cholesteatoma is a new cholesteatoma that develops when the underlying causes of the initial cholesteatoma are still present.
This is the most common and widely considered as the main reason for cholesteatoma.
Skin material often accumulates in this pocket and becomes infected causing drainage and potential severe complications.
Invagination of the tympanic membrane of the attic to form retraction pockets to be filled with desquamated epithelium and keratin to form cholesteatoma.
1 attic retraction pocket cholesteatoma is clearly visualized white arrow.