A retraction pocket cholesteatoma of the posterosuperior quadrant with erosion of the incus long process

A retraction pocket cholesteatoma of the posterosuperior quadrant. The incus long process is eroded, leaving the drum adherent to the stapes head (S). An effusion is present in the middle ear, and squamous debris emanates from the attic (the pneumatized space just superior to the middle ear, also called the epitympanum).