Attic Retraction Pocket

For retraction pockets the meatal skin flap length must be at least 8 10 mm.

Attic retraction 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. An attic cholesteatoma is defined as an epidermoid cyst found in the attic. Attic retraction pocket in the left ear white arrow with atelectatic prussak s space red circle and eroded scutum yellow arrow. 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.

Skin material often accumulates in this pocket and becomes infected causing drainage and potential severe complications. There has been significant bone erosion of the ear canal wall above the eardrum. 1 attic retraction pocket cholesteatoma is clearly visualized white arrow. 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. This is differentiated from an infected retraction pocket of the pars tensa or a retraction pocket cholesteatoma.