Tympanic membrane retraction describes a condition in which a part of the eardrum lies deeper within the ear than its normal position.

Tympanic membrane retraction is fairly common and has been observed in one quarter of a population of British school children.

This may be caused by disrupted gas exchange in the middle ear mucosa, inadequate opening of the Eustachian tube or a combination of these factors.

This layer may be weaker in the postero-superior quadrant (top rear quarter) or after the eardrum heals after perforation or tympanostomy tubes (grommets) so predispose to retraction in these areas.

This process of proliferation and migration can result in enlargement of a retraction pocket so that the eardrum expands and grows deeper into the ear.

The majority of tympanic membrane retractions remain stable for long periods of time, or may even resolve spontaneously so that the eardrum becomes normal again.

There is no simple clinical means of identifying which ears will deteriorate to accumulate keratin debris in the pars tensa retraction, a phenomenon that is not influenced by age.

Various strategies may be used to manage tympanic membrane retraction, with the aims of preventing or relieving hearing loss and cholesteatoma formation.

Adenoidectomy can improve middle ear function[11] and nasal steroid sprays can reduce adenoid size[12] but it is not known whether these treatments alter tympanic membrane retraction.

Enlargement of the Eustachian tube opening in the nose with laser or balloon dilation is being evaluated as a potential treatment for tympanic membrane retraction.

[13][14] There are two methods for this technique: Dennis Poe popularized the transnasal introduction of the balloon catheter to dilate the distal (nose end of the Eustachian tube).

[14] Muaaz Tarabichi pioneered the dilatation of the proximal (ear side of the eustachian tube) through transtympanic (trans-ear) introduction of the balloon catheter.