Tos Classification - Pars Flaccida Retraction

Otology Classifications and Gradings in ENT

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👂 Tos Classification of Pars Flaccida Retraction

Tos Classification of Pars Flaccida Retraction

✅ Stage 1: Mild Retraction

Minimal dimpling of pars flaccida.
Not in contact with the neck of malleus.
Retraction is visible but not adherent.

✅ Stage 2: Contact with Neck of Malleus

Pars flaccida is retracted and adherent to the neck of the malleus.
Entire retraction pocket is visible on otoendoscopy.

✅ Stage 3: Partial Erosion of Scutum

Part of the retraction pocket is out of view.
There is partial erosion of the bony attic wall (scutum).
The retraction is deeper and begins to hide in the attic.

✅ Stage 4: Severe Retraction and Erosion

Severe erosion of the scutum.
Retraction pocket is deep, not fully visible.
Complete adherence to surrounding structures.

📝 Summary Table

Stage	Key Features
1	Mild retraction, not touching malleus
2	Adherent to neck of malleus, fully visible pocket
3	Partial scutum erosion, pocket partly hidden
4	Severe erosion, deep non-visible pocket

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