Cholesteatoma Attic Retraction

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

Cholesteatoma attic retraction.

There has been significant bone erosion of the ear canal wall above the eardrum. Granulation tissue may arise from the mucosa adjacent to the cholesteatoma figure 6c. Such causes can include for example poor eustachian tube function which results in retraction of the ear drum and failure of the normal outward migration of skin. Eustachian tube theory.

1 attic retraction pocket cholesteatoma is clearly visualized white arrow. A recurrent cholesteatoma is a new cholesteatoma that develops when the underlying causes of the initial cholesteatoma are still present. 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.

There is an attic erosion partially exposing posterior half of drum deeply retracted and this pocket is full of keratin flakes. Skin material often accumulates in this pocket and becomes infected causing drainage and potential severe complications.