1 - Normal Eardrum
1 Long Process Malleus
2 Short Process Malleus
3 Umbo
4 Long Crus Incus
5 Pars Flaccida
6 Light Reflex
7 Fibrocartilaginous Annulus
8 Round Window Shadow
9 Stapes
2 - Serous Otitis Media
The meniscus of the air-fluid level is observed in the posterior superior quadrant.
3 - Serous Otitis Media
Multiple Air fluid levels (bubbles) are observed in the superior quadrants.
4 - "Glue Ear"
A dark middle ear effusion is noticed in the Middle Ear.
There is an Attic retraction.
5 - Status Post Tubulation
There is a ventilating tube located in the anterior inferior quadrant.
6 - Status Post Tubulation
The tube is plugged by dry mucous material.
7 - Status Post Tubulation
The tube is plugged by granulation tissue.
8 - Status Post Tubulation
Posterior Inferior Perforation after tubulation.
Visible round window.
Scattered areas of tympanosclerosis in the inferior part of the Eardrum.
9 - Acute Otitis Media
Markedly opaque and erythematous Eardrum and medial Ear Canal.
Edema and increased vascularity.
Mild bulging.
10 - Acute Otitis Media Severe
Bulging Eardrum.
Severe edema.
Purulent material in the middle ear.
Loss of markings.
11 - Acute Otitis Media
Status post acute perforation.
Mosaic appearance of keratinous epithelium.
12 - Granular Myringitis
Eardrum perforation with formation of inflammatory tissue around the perforation and on the surface of the eardrum.
An white area of calcium deposit is observed secondary to repetitive inflammatory processes.
14 - Chronic Suppurative Otitis Media
Chronic perforation of the Eardrum with otorrhea usually due to an infectious process of the mastoid and the middle ear. Increased accumulation of debris due to the persistent drainage. Ossicles may became eroded.
15 - Chronic Dry Perforation of the Eardrum
There is tympanosclerosis and hypotympanic cells are visible. The Middle Ear is dry a clean.
Safe perforation buy may impair hearing.
16 - Dimeric membrane
Thin weak area of the eardrum after a perforation that lacks the fibrous component of the eardrum.
Area of tympanosclerosis is visible.
17 - Adhesive Otitis Media
Collapse of the Pars Tensa of the eardrum over the promontory.
Attic retraction.
Round window visible.
18 - Myringoincudostapedopexy
Attic Retraction
Tympanosclerosis
The dimeric membrane rests on the Stapes head and a portion of the eroded long process of the Incus. The Lenticular process is absent.
19 - Myringostapedopexy
Attic Retraction
Tympanosclerosis
The retracted eardrum rests on the promontory, the Incus has been eroded and it is absent. Attic retraction. The Malleus is retracted towards the promontory showing a prominent short process.
20 - Myringostapedopexy
The retracted eardrum has eroded the Incus and rests over the Sapes head. The Stapes tendon is visible.
An accumulation of keratinous debris is seen from the area of the retraction.
21 - Eardrum perforations.
Multiple dry perforations are seen in the Eardrum.
22 - Eardrum Perforation
(Chronic Purulent
Otitis Media)
Multiple wet perforations are seen in the Eardrum.
23 - Eardrum Perforation Marginal
The perforation has involved par of the Fibrous Annulus are the Incus and Stapes are absent.
24 - Bullous Myringitis
A bleb is seen on the surface of the Eardrum.
Occasionally may be hemorrhagic.
25 - Attic Retraction
A large clean Attic retraction is observed.
26 - Cavernous Hemangioma of the Ear Canal and Eardrum
Congenital lesion frequently asymptomatic.
27 - "Port Wine Stain" of the Ear Canal and Eardrum (Nevus Flammeus).
Congenital lesion caused by a capillary malformation of the skin.
28 - Acute Traumatic Perforation of the Eardrum.
Perforation due to blast injury.
29 - Chronic Traumatic Perforation of the Eardrum.
The process of healing has started frequently associated with bleeding.
30 - Intratympanic
Hemorrhage
Observed after Scuba Diving incident.
31 - Middle Ear Hemorrhage
Observed after epistaxis ans nose blowing.
32 - Middle Ear Hemorrhage after Base of Skull Fracture
There is bulging of the Eardrum and deformity of the superior part of the Ear Canal.
33 - Middle Ear Hemorrhage after Base of Skull Fracture
Rupture of the Eardrum with deformity of the Ear Canal and bleeding.
34 - Attic Cholesteatoma.
A large Attic defect is seen with accumulation of keratinous material.
35 - Mastoid Cholesteatoma.
A defect by erosion is seen in the posterior superior aspect of the Eardrum with accumulation of keratinous material. No middle ear ossicles are observed.
36 - Mastoid Cholesteatoma.
A defect by erosion is seen in the posterior superior aspect of the Eardrum with accumulation of keratinous material and granulation tissue.
37 - Eardrum Cholesteatoma.
A cholesteatoma pearl is seen at the level of the Umbo.
38 - Congenital Cholesteatoma.
A Cholesteatoma is seen in the middle ear with an intact Eardrum.
39 - Keratosis Obturans (Canal Colesteatoma)
An accumulation of hard keratinous material is present in the Ear Canal.
A large amount of dry keratinous debris is obse4erved. (See slide No. 40).
40 - Keratosis Obturans ("Canal Colesteatoma")
Same patient of Slide No. 39.
The hard keratinous material has been removed and a bony defect is observed in the Ear Canal.
41 - Keratosis Obturans ("Canal Colesteatoma")
Severe erosion of the Ear Canal with bone exposure.
42 - Cholesteatoma of the Eardrum.("Epidermal Inclusion Cysts")
Two cysts are observed in the Eardrum and also an inferior perforation.
Lesions are iatrogenic after Lateral Tympanoplasty.
43 - Cholesteatoma of the Ear Canal
(Epidermal Inclusion Cysts")
There is a tubulation and an area of Tympanosclerosis.
Lesion of the Ear Canal could be iatrogenic after surgery.
44 - Eardrum Lateralization
The Eardrum has pulled away from its anatomical area after a Lateral Tympanoplasty.
45 - Seborrheic Dermatitis. ("Eczematous")
Itchy desquamation of the Ear Canal.
46 - Acute External Otitis
Marked painful edema of the Ear Canal.
47 - Acute External Otitis Otomycosis
Accumulation of mycotic material (Aspergillus niger) is observed. (See Slide No. 48)
48 - Acute External Otitis Otomycosis
(After cleaning)
Same patient of Slide No. 47 after cleaning of the Ear Canal.
49 - Acute External Otitis Otomycosis
White cotton type material fills the Ear Canal. (Candida albicans.)
50 - Acute External Otitis TRAUMATIC
Erosion of the epithelium and subcutaneous hematoma.
51 - Stenosis Ear Canal (Factitial)
Due to chronic abusive use of Q-tips.
52 - Cerumen Impaction
53- Fracture Base of Skull.
Totally healed fracture.
There is deformity of the Ear Canal.
The Corda Tympany is visible.
54 - Status Post Stapedectomy
The Stapes Prosthesis is seeing in the Middle Ear attached to the Incus.
Areas of Tympanosclerosis present in the posterior superior quadrant.
55 - Status Post Fenestration
The Lateral Semicircular Canal has been fenestrated for the treatment of Otosclerosis.
56 - Foreing Body Ear Canal
Rock.
57 - Foreign Body Ear Canal
Small insect.
58 - Foreign Body Ear Canal
Sand.
59 - Foreign Body Ear Canal
Insect.
60 - Foreign Body Ear Canal
Large insect.
61 - Foreign Body Ear Canal
Large arachnid TICK (ectoparasite).
62 - Osteomas Ear Canal. (Multiple)
Small multiple Osteomas of the Ear Canal.
63 - Osteoma Ear Canal. (Single)
64 - Congenital Nevus Ear Canal
65 - Cholesterol Granuloma of the Middle Ear
A dark granuloma is observed thru a dimeric membrane. Tympanosclerosis around the Fibrous Annulus,
66 - Basal Cell Carcinoma of the Ear Canal
The erosive lesion is seeing in the anterior and superior portion of the Ear Canal.
67 - Spinal Fluid Fistula to Middle Ear (After Trauma)
A clear effusion is seeing in the Middle Ear. There is bulging of the Eardrum, and also the Attic and the superior posterior area of the Ear Canal.
68 - Congenital Cholesteatoma
It fills the Middle Ear behind an intact Eardrum.
69 - Middle Ear Tumor
Papillary Adenoma of the Middle Ear.
70 - Glomus Tumor Middle Ear
The tumor fills the hypotypanum. (Rising Sun sign).
71 - Glomus Tumor Filling Ear Canal
The tumor has extruded and fills the Ear Canal.
72 - Status Post Tympanoplasty
Fascia graft Tympanoplasty.
73 - Status Post Tympanoplasty
Cartilage Tympanoplasty.
74 - Status Post Tympanoplasty Interposition
Cartilage is observed under an eroded Long Process of the Incus. (Interposition Incus - Stapes)
75 - Atticotomy
76 - Expanded Atticotomy
77 - Atticomastoidectomy
High bridge.
78 - Radical Mastoidectomy
Radical Atticomastoidectomty with Myryngostapedopexy.
79 - Radical Mastoidectomy
Radical Mastoidectomy with a low bridge.
80 - Radical Mastoidectomy - Blue Dohme Cyst
A Blue Dohme Cyst - (Cholesterol Granuloma) is seen in a Radical Mastoid cavity.
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