Objective: To analyze the clinical manifestation of attic retraction pocket.
Method: Ninety-two patients with 118 involved ears were studied. The clinical data including clinical manifestation, endoscopic findings and gradings,hearing tests, imaging findings and accompanying lesions.
Result: According to Tos's grades, 15 ears (14/118,12.7%) belonged to stage I, 48 (42/118, 40.7%) belonged to stage II, 23 (23/104,19.5%) belonged to stage III and 32 (32/118, 27.1%) belonged to stage IV. Patients always complained of ear blockage,hearing loss and tinnitus. Accompanying lesions including otitis media with effusion, middle ear atelectasis, adhesive otitis media and retraction pocket cholesteatoma could be found by endoscopy. The results of pure audiometry were related to the grades of lesions. Most patients had conductive hearing loss and a few patients had mixed hearing loss. The tympanometry in most cases was type B or C. Imaging examination (CT or X-ray) of 97 ears showed poor pneumatization of mastoids and there was a significant difference between involved group and control group (P < 0.01).
Conclusion: The attic retraction pocket reflected the negative pressure of middle ear and its pathogenesis was related with the function of Eustachian tube, inflammation and pneumatization of mastoid. Since it had a risk to develop into retraction pocket cholesteatoma, following-up and interferon to early or middle stage lesion should be paid more attention.