Complete opacification of the right epitympanic space including Prussak's space. The anterior aspect of the right epitympanic space appears expanded and there is erosion of the anterior portion of the scutum (correlate with clinical photographs above). There is also erosion of the malleus head and long process of the incus. The tegmen tympani appears intact.
The mastoid is poorly pneumatised, sclerotic and fully opacified, an indicator of long standing middle ear disease. The cochlea, vestibule, semicircular canals and facial nerve canal appear intact.
Imaging confirms epitympanic cholesteatoma.