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The scutum is not eroded as is typically seen in pars flaccida (attic) acquired cholesteatoma. In this case the floor of the middle ear cleft contains soft tissue denisty material that erodes the adjacent bone but not the semicircular canals. Ossicles are pushed up and stapes is not well seen (possibly eroded). This inferior and posterior part of the affected drum is called the pars tensa and is thicker thus less prone to perforation. Nonetheless cholesteatoma can occur in this location.