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Review
. 2021 Apr 28;57(5):425.
doi: 10.3390/medicina57050425.

Pathogenesis of Retraction Pocket of the Tympanic Membrane-A Narrative Review

Milan Urík  1 , Miroslav Tedla  2 , Pavel Hurník  3   4
Affiliations
Review

Pathogenesis of Retraction Pocket of the Tympanic Membrane-A Narrative Review

Milan Urík et al. Medicina (Kaunas). .

Abstract

Several theories describe the development of the retraction pocket of the tympanic membrane (RP). Many authors suggest that the negative middle ear pressure is the main reason responsible for developing this condition. A narrative review has been undertaken, and conclusions are drawn reflecting a current knowledge with our new observations in the histological and immunohistochemical study. Recent studies show the important role of inflammation in the development and progression of RP. A review of the available literature shows that the inflammation plays a key role in pathogenesis of the RP and its progression to the cholesteatoma. We support this statement with our new results from histological and immunohistochemical analysis of the RPs.

Keywords: cholesteatoma; chronic otitis media; pathogenesis; pathology; retraction pocket; tympanic membrane.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Retraction pocket of pars tensa caused erosion of the incudostapedial joint. formula image Malleus, formula image Erosion of the incudostapedial joint.
Figure 2
Figure 2
Fragmentation of the elastic fibers in the middle layer of tympanic membrane, histology of retraction pocket, Verhoeff, (400×). formula image External epithelial layer, formula image Basal membrane, formula image Fragmented elastic fibers in the middle layer.
Figure 3
Figure 3
Immunohistochemistry–CD45 LCA, inflammation (200×). formula image External epithelial layer, formula image Basal membrane, formula image Rete peg (area of ingrowing squamous epithelium), formula image White blood cells of all categories (CD45 LCA+).
Figure 4
Figure 4
Immunohistochemistry–MMP9 in the middle layer of tympanic membrane (200×). formula image External epithelial layer, formula image Middle layer of the tympanic membrane, formula image MMP9+.
See this image and copyright information in PMC

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