Related Experiment Video
Updated: Nov 14, 2025
Author Spotlight: Advancing Endoscopic Ossiculoplasty – Techniques, Innovations, and Practical Guidance for Clinical Integration
Published on: January 26, 2024
Management of tympanic membrane retractions: a systematic review
Ahmed B Bayoumy1, Christianne C A F M Veugen2, Erwin L van der Veen3
1Department of Otolaryngology, Ministry of Defense, Central Military Hospital, Utrecht, The Netherlands. a.b.bayoumy@amsterdamumc.nl.
Importance:
Tympanic membrane retraction (TMR) is a relatively common otological finding. However, no consensus on its management exists. We are looking especially for a treatment strategy in the military population who are unable to attend frequent follow-up visits, and who experience relatively more barotrauma at great heights and depths and easily suffer from otitis externa from less hygienic circumstances.
Objective:
To assess and summarize the available evidence for the effectiveness of surgical interventions and watchful waiting policy in patients with a tympanic membrane retraction.
Evidence Review:
The protocol for this systematic review was published at Prospero (207859). PubMed, Embase, and the Cochrane Database of Systematic Reviews were systematically searched from inception up to September 2020 for published and unpublished studies. We included randomized trials and observational studies that investigated surgical interventions (tympanoplasty, ventilation tube insertion) and wait-and-see policy. The primary outcomes of this study were clinical remission of the tympanic membrane retraction, tympanic membrane perforations and cholesteatoma development.
Findings:
In total, 27 studies were included, consisting of 1566 patients with TMRs. We included data from 2 randomized controlled trials (76 patients) and 25 observational studies (1490 patients). Seven studies (329 patients) investigated excision of the TMR with and without ventilation tube placement, 3 studies (207 patients) investigated the wait-and-see policy and 17 studies (1030 patients) investigated tympanoplasty for the treatment of TMRs.
Conclusions And Relevance:
This study provides all the studies that have been published on the surgical management and wait-and-policy for tympanic membrane retractions. No high level of evidence comparative studies has been performed. The evidence for the management of tympanic membrane retractions is heterogenous and depends on many factors such as the patient population, location and severity of the TMR and presence of other ear pathologies (e.g., perforation, risk of cholesteatoma and serous otitis media).
Related Concept Videos
01:14Assessing Body Temperature - Tympanic membrane
Step 1: Begin by practicing good hand hygiene to prevent the transmission of microorganisms.
Step 2: Turn on the thermometer and wait until the ready sign appears on the screen to ensure accurate measurement.
Step 3: Slide the probe cover in place to prevent cross-contamination.
Step 4: Instruct the patient to tilt their head to the side for comfort and check for cerumen...
01:26Tonsillitis II: Management
01:23Chronic Pharyngitis
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
01:29Suctioning the Nasopharyngeal Airway
Equipment Required
01:17Pericarditis III: Medical Management
01:30Epistaxis
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...