Attic Retraction Pocket

Either or both of these parts may become retracted.

Attic retraction pocket.

This retraction pocket is still cleaning itself but the extent of the pocket can not be seen. Skin material often accumulates in this pocket and becomes infected causing drainage and potential severe complications. 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. 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.

An attic cholesteatoma is defined as an epidermoid cyst found in the attic. It is disappearing out of view arrow2 so skin may be collecting deeper in the ear. Tympanic membrane retraction describes a condition in which a part of the eardrum lies deeper within the ear than its normal position. 1 attic retraction pocket cholesteatoma is clearly visualized white arrow.

Eventually the pocket may trap skin forming a skin cyst or cholesteatoma. The retracted segment of eardrum is often known as a retraction pocket. There has been significant bone erosion of the ear canal wall above the eardrum. 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.

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. For retraction pockets the meatal skin flap length must be at least 8 10 mm. Management of controlled posterior or posterior attic retraction pockets tympanomeatal flap incision. This picture shows a severely retracted left eardrum with retraction pocket formation.

There is an attic retraction pocket and a large posterior inferior retraction of the eardrum which is draped over the promontory. 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. Pockets may be formed in any part of the tympanic membrane but typically are located in epitympanum. Go to top long term retraction of the eardrum will cause erosion of the ear canal and forms a deep pocket.

This is differentiated from an infected retraction pocket of the pars tensa or a retraction pocket cholesteatoma. Further progression of retraction pockets can cause destruction of the eardrum.