Contemporary management of tympanic membrane retraction

Tympanic membrane retraction is a common condition in otology. In most cases, it does not lead to significant complications. However, because there is a risk of progression to cholesteatoma, accurate diagnosis and appropriate management are crucial. In this review, we present the diagnostic strategy and the conservative or surgical management options available for patients with tympanic membrane retractions.

Diagnosis is primarily clinical and tympanic membrane retractions may be incidentally identified in asymptomatic patients. Conservative management through close observation remains the first-line approach for mild to moderate retractions. Surgical interventions, including ventilation tube insertion, cartilage tympanoplasty, Eustachian tube balloon dilatation, and mastoid procedures, are generally reserved for cases complicated by cholesteatoma or significant hearing impairment.

Evidence-based consensus on optimal management is lacking. Prospective or randomized studies are needed to establish validated management strategies.