Ear Attic Retraction Pocket

A retraction pocket seen in the attic or posterosuperior quadrant of a tympanic membrane is the hallmark of an acquired cholesteatoma.

Ear attic retraction pocket.

The basal cells of germinal layer of skin proliferate under the influence of infection and lay down keratinising squamous epithelium. Granulation tissue may arise from the mucosa adjacent to the cholesteatoma figure 6c. Many of theses eardrums have tympanosclerosis or white plaques on the eardrum. Further progression of retraction pockets can cause destruction of the eardrum.

Often there is an accumulation of squamous debris within the pocket figure 6a b. This retraction pocket is still cleaning itself but the extent of the pocket can not be seen. Tympanic membrane retraction describes a condition in which a part of the eardrum lies deeper within the ear than its normal position. 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 either or both of these parts may become retracted.

1 attic retraction pocket cholesteatoma is clearly visualized white arrow. 5 ruedi s theory. Eardrum is strongly retracted one can not determine the exact position of its banks the destruction of the lateral wall of the attic is larger and the epithelium begins to grow into the back forming the initial stage of cholesteatoma. 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.

The picture on the far right shows a severely retracted eardrum with attic retraction pocket formation. The ear drum has worn away a lot of the middle hearing bone. Invagination of tympanic membrane from the attic or part of pars tensa in the form of retraction pockets lead to the formation of cholesteatoma. A retracted eardrum usually doesn t cause any symptoms.

Fluid draining from the ear. Attic retraction pocket in the left ear white arrow with atelectatic prussak s space red circle and eroded scutum yellow arrow. The the photo 3 you can see the uncontrolled retraction pocket in epitympanum. Skin material often accumulates in this pocket and becomes infected causing drainage and potential severe complications.