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A Safe Tympanic Retraction with an Unsafe Disease Entity

Preprint Archives of Clinical Images & Videos. 2017;1(1):1
DOI: 10.24983/scitemed.paciv.2017.00003
Article Type: Image

Abstract

Keywords

    Despite a lack of evidence to support or refute an optimal strategy for the management of tympanic retractions, retraction pockets with clear and clean bottoms are generally considered “safe” or “stable”. We present one case of a tympanic retraction pocket that could cause clinicians to miss or delay diagnosis of retraction-associated complications. Otoscopic examination of the left ear (Panel A) revealed a deep retraction pocket of the par flaccida with severe scutum erosion (arrow in Panel B). Although the pars tensa was normal (arrowhead in Panel B), the malleus head was exposed and wrapped by the par flaccida (arrow in Panel C). The bottom of the retraction pocket was clear and clean and showed no signs of infection or debris accumulation. Pre-operative high-resolution CT scan of the left temporal bone (Panel D and E). The coronal view of CT scan shows scutum erosion (arrow in Panel D) and a soft tissue mass in the mastoid (arrow in Panel E). Surgeons should be aware of the fact that tympanic retraction pockets are not necessarily safe, even if they have clean and clear bottoms.

    Editorial Information

    Publication History

    Received date: April 30, 2017
    Accepted date: April 30, 2017
    Published date: May 02, 2017

    Copyright

    © 2017 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY).

    1. Department of Otolaryngology-Head and Neck Surgery, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
    2. Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
    Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
    Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
    Email: cflien@vghtpe.gov.tw