Attic Retraction Pocket Cholesteatoma

The patient was elderly and had very poor hearing in this ear.

Attic retraction pocket cholesteatoma.

A retraction pocket seen in the attic or posterosuperior quadrant of a tympanic membrane is the hallmark of an acquired cholesteatoma. Auris nasus larynx vol. However this ear was also the patient s only hearing ear and there was not a history of pain or drainage. The picture on the right shows a large cholesteatoma with a very large and open attic retraction pocket and a central perforation of the eardrum.

Incidence of attic retraction after staged intact canal wall tympanoplasty for middle ear cholesteatoma. 1 attic retraction pocket cholesteatoma is clearly visualized white arrow. Often there is an accumulation of squamous debris within the pocket figure 6a b. Invagination of the tympanic membrane of the attic to form retraction pockets to be filled with desquamated epithelium and keratin to form cholesteatoma.

The significance of the retraction pocket in the treatment of cholesteatoma. An attic cholesteatoma is defined as an epidermoid cyst found in the attic. Granulation tissue may arise from the mucosa adjacent to the cholesteatoma figure 6c. This is the most common and widely considered as the main reason for cholesteatoma.

This is differentiated from an infected retraction pocket of the pars tensa or a retraction pocket 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. There has been significant bone erosion of the ear canal wall above the eardrum.