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This pathological version of Bone 3 presents the surgeon with an attic perforation and a cholesteatoma of indeterminate extent. Thus he/she must choose and carry out the most appropriate procedure, be it atticotomy, intact canal wall or open cavity surgery.
The smaller photograph shows the cholesteatoma enveloping the head of the malleus and body of the incus, the facial nerve is medial to the long process of the incus.
The larger photograph shows a Bone 3 modified radical mastoidectomy. Can you identify the head of the stapes, the promontory, round window niche, horizontal part of the facial nerve, procesus cochleariformus, lateral semicircular canal, promontory, skin of external auditory canal and tympanic membrane (folded), mastoid cavity, middle fossa plate, sinodural angle, sigmoid sinus, facial "ridge," mastoid cells?
