Surgery for tympanic membrane retraction pockets

The tympanic membrane, or eardrum, is a thin piece of tissue that separates the external ear from the middle ear. Its main function is to transmit sound from the air to the three small bones of the middle ear. A retraction of the tympanic membrane happens when all or a segment of the membrane collapses inwards towards the middle ear. Tympanic membrane retractions are commonly managed by ENT surgeons but there is currently no consensus as to the indications, timing and options for management of this condition. We identified only two randomised controlled trials, involving 71 participants, which could be included in this review. One was a small study which showed no statistically significant benefit of cartilage graft tympanoplasty over a watch and wait policy, either for disease progression or hearing. The other showed no additional benefit from the insertion of ventilation tubes ('grommets') over cartilage tympanoplasty alone for patients' hearing. Further high quality studies are much needed.