Attic Retraction Pocket

The retracted segment of eardrum is often known as a retraction pocket.

Attic retraction pocket.

The terms atelectasis or sometimes adhesive otitis media. The eardrum comprises two parts the pars tensa which is the main part of the eardrum and the pars flaccida which is a smaller part of the eardrum located above the pars tensa. It is disappearing out of view arrow2 so skin may be collecting deeper in the ear. Management of controlled posterior or posterior attic retraction pockets tympanomeatal flap incision.

Further progression of retraction pockets can cause destruction of the eardrum. Go to top long term retraction of the eardrum will cause erosion of the ear canal and forms a deep pocket. One can describe a retraction pocket as a condition where part of the tympanic membrane is drawn towards the middle ear space and lies deeper than a healthy part. Pockets may be formed in any part of the tympanic membrane but typically are located in epitympanum.

Tympanic membrane retraction describes a condition in which a part of the eardrum lies deeper within the ear than its normal position. This retraction pocket is still cleaning itself but the extent of the pocket can not be seen. 1 attic retraction pocket cholesteatoma is clearly visualized white arrow. Eventually the pocket may trap skin forming a skin cyst or cholesteatoma.

For retraction pockets the meatal skin flap length must be at least 8 10 mm. The present study describes an improved classification system based on otoscopic and endoscopic visualization of the retraction pocket fundus the ossicular status in the attic degree of scutal erosion and the presence or absence of cholesteatoma. There is an attic retraction pocket and a large posterior inferior retraction of the eardrum which is draped over the promontory. The ear drum has dropped further in and has worn through the middle hearing bone arrow 1 and is now lying against the inner wall of the middle ear space.

Skin material often accumulates in this pocket and becomes infected causing drainage and potential severe complications. Although attic retractions have previously been classified into grades 0 through iv it is often not possible to assign attic retraction pockets into a single specific category. A retraction pocket with little epitympanic erosion can be managed using a transmeatal approach with or without extended tympanoatticotomy. Stratified squamous epithelium may also be present in the middle ear as other clinical or pathological entities such as metaplastic islands of the mucosa in chronic ears with central perforations.

Either or both of these parts may become retracted. This picture shows a severely retracted left eardrum with retraction pocket formation.