The most common ossicle to be eroded by cholesteatoma is the:

• A Head of malleus
• B Stapes superstructure
• C Body of incus
• D Long process of incus ✓

Explanation

The long process of the incus is the most vulnerable ossicle in cholesteatoma, primarily because it has a precarious blood supply (from the tympanic plexus alone, with no medullary supply) and lies in the path of cholesteatoma expansion from Prussak's space posteriorly and inferiorly. Erosion of the long process causes a discontinuity in the ossicular chain with a maximum air-bone gap of about 60 dB. Incus transposition or ossiculoplasty is needed during reconstruction.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.