Pars Tensa Retractions

 

In the same way that the pars flaccida is vulnerable to retraction, the pars tensa may also become retracted.  This usually occurs at the posterosuperior section of the pars tensa, where it may involve the long process of the incus, stapes and other middle ear structures.

 

 

The whole of the pars tensa is retracted onto the medial wall of the middle ear.  The head of the stapes and the stapedial tendon are visible.  The handle of the malleus is considerably medialised.