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Management of retraction pockets: historic and novel approaches

Published online by Cambridge University Press:  07 January 2022

D Spinos Open the ORCID record for D Spinos [Opens in a new window] ,
S Mallick  and
O Judd
D Spinos*
Affiliation:
Department of Otolaryngology, Royal Derby Hospital, University Hospitals of Derby and Burton NHS Trust, Derby
S Mallick
Affiliation:
Department of Otolaryngology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, UK
O Judd
Affiliation:
Department of Otolaryngology, Royal Derby Hospital, University Hospitals of Derby and Burton NHS Trust, Derby
*
Author for correspondence: Mr Dimitrios Spinos, 26 Angelica Close, Littleover, DerbyDE23 1NJ, UK E-mail: dimi.spinos@gmail.com
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Abstract

Background

Retraction pockets are collapsed segments of the tympanic membrane. Their formation is associated with a disruption in middle-ear ventilation pathways, leading to the loss of organised collagen of the tympanic membrane. There are several approaches in treating retraction pockets, which aim either to improve ventilation or repair the retraction pockets themselves.

Methods

A review of the literature regarding the classification and associated management of retraction pockets was conducted, using Medline and Cochrane Library databases, with the addition of our institution's experience in undertaking novel techniques.

Results

All the current classification systems fail to guide treatment or prognosticate the disease. Commonly, an initial conservative approach is suggested for early stages, with no clear indication regarding when a surgical solution should be offered. There are conflicting data concerning the effectiveness of these treatments in terms of disease prevention, recurrence and hearing outcomes.

Conclusion

Minimally invasive approaches utilising novel techniques may be key to reducing peri-operative morbidity and improving the overall patient experience.

Keywords

OtologyTympanoplastyLasersEndoscopy
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 7 , July 2022 , pp. 582 - 587
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Mr D Spinos takes responsibility for the integrity of the content of the paper

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