The strategy for management of tympanic membrane retractions

I have read with great interest the article by Lee et al. [1], who raised an important issue on tympanic membrane retractions. The authors concluded that attic cholesteatoma may present as a tiny retraction of the pars flaccida; therefore, attic retractions should be observed closely in spite of tiny retractions or normal hearing. We appreciate the authors' effort to arouse clinicians' awareness on the potential risk of tympanic membrane retractions. In particular, the authors' observation evokes a more challenging question: what is the optimal strategy for management of tympanic membrane retractions?

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