Retraction pockets in the tympanic membrane - aetiology and management - our view point.

Retraction pockets of the tympanic membrane are believed to be due to eustachian tube obstruction or malfunction. Our observations based on intraoperative findings suggest that the presence of a large sized mastoid antrum along with chronic eustachian tube obstruction plays an important role in the causation of retraction pockets. Granular myringitis may also occur in these circumstances when there is a recurrent eustachian tube blockage due to infection especially if the patient has received frequent and inadequate courses of antibiotics. The use of chromic catgut to create a healed air-filled middle ear space along with a canal wall down tympanomastoidectomy is discussed for their effective treatment.