Attic Retraction Pocket

1 attic retraction pocket cholesteatoma is clearly visualized white arrow.

Attic retraction pocket. Attic retraction pocket in the left ear white arrow with atelectatic prussak s space red circle and eroded scutum yellow arrow. 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. Skin material often accumulates in this pocket and becomes infected causing drainage and potential severe complications. 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.

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. This is differentiated from an infected retraction pocket of the pars tensa or a retraction pocket cholesteatoma. A retraction pocket with little epitympanic erosion can be managed using a transmeatal approach with or without extended tympanoatticotomy. For retraction pockets the meatal skin flap length must be at least 8 10 mm.

There has been significant bone erosion of the ear canal wall above the eardrum. Pockets may be formed in any part of the tympanic membrane but typically are located in epitympanum.