| REVIEW ARTICLE |
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| Year : 1998 | Volume
: 1
| Issue : 1 | Page : 5-16 |
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Tympanic membrane retraction: Pathogenesis and management
B Ars
Consultant University (U.Z.A), Temporal Bone Foundation, Brussels, Belgium
Correspondence Address:
M.D., PhD B Ars
Consultant University (U.Z.A) Temporal Bone Foundation, Avenue du Polo, 68, 1150, Brussels
Belgium
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/1319-8491.286858
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Tympanic membrane retraction pocket is a clinical entity which results from a disease of the whole middle ear cleft.
Numerous causes are involved in the genesis of the retraction pocket; among which are the presence of an inflammatory process of the upper air ways mucosa, middle ear cleft negative pressure, tympanic membrane lamina propria atrophy and stratified squamous epithelium dysfunction. All these factors directly or successively are increased by the concomitant effect of local morphological factors which predispose to the genesis of the retraction pocket.
The management of tympanic membrane retraction pocket may be divided into two main methods. The preventive management consists of routine examination under the operating microscope and suction, if necessary, with the endoscope, as well as medico-surgical intervention intended to provide the appropriate treatment of the whole middle ear cleft mucosa inflammation. The curative management varies according to the developmental character of the pathological process. It is conservative at level I.
The stabilised retraction pocket of level II requires the insertion of an aerating tube and the excision of the atelectatic part of the drum. The destabilised retraction pocket corresponding to level III, needs replacement of the diseased membrane such as a total allograft myringoplasty, associated with a restoration of the volume of the mastoid air cells system.
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