On the left side, the external auditory canal is patent. The tympanic membrane is thickened. There is a soft tissue mass located in the anterior, medial epitympanum and mesotympanum intimately associated with the malleolus and incus resulting in mild demineralization of the head of the malleus. There is mild remodeling of the anterior middle ear cavity. The tegmen tympani, facial nerve,and lateral semicircular canal are intact.