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.

1 attic retraction pocket cholesteatoma is clearly visualized white arrow. Eustachian tube theory. There has been significant bone erosion of the ear canal wall above the eardrum. Skin material often accumulates in this pocket and becomes infected causing drainage and potential severe complications.

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. There is an attic erosion partially exposing posterior half of drum deeply retracted and this pocket is full of keratin flakes. Primary acquired cholesteatoma or retraction cholesteatoma this form of cholesteatoma is due to a ventilation malfunction in the middle ear often caused by insufficient tube permeability.

Invagination of the tympanic membrane of the attic to form retraction pockets to be filled with desquamated epithelium and keratin to form cholesteatoma. Granulation tissue may arise from the mucosa adjacent to the cholesteatoma figure 6c.