Objective: To synthesize the published clinical and paraclinical literature on tympanic membrane (TM) atelectasis, with particular attention to early-stage disease (Sadé grade I and II), and to summarize the evidence supporting conservative and surgical management as a basis for a planned prospective cohort study at a regional referral hospital in northern Vietnam. Methods: A structured search of PubMed/MEDLINE and Vietnamese domestic otorhinolaryngology journals was conducted for studies published between January 2010 and July 2026 addressing the pathogenesis, otoendoscopic and audiometric characteristics, tympanometric and computed-tomographic findings, or treatment outcomes of TM atelectasis or retraction pockets. Systematic reviews, narrative reviews, prospective and retrospective cohorts, and case series were eligible when they reported an extractable clinical, functional, or surgical outcome. Twenty-six clinical studies were retained for structured synthesis, supported by six additional references on pathogenesis, staging, or outcome-instrument validation. Because diagnostic criteria, staging systems, and outcome measures varied across studies, no pooled effect estimate was attempted. Results: The reviewed literature converged on eustachian tube dysfunction and sustained negative middle-ear pressure, combined with acquired weakness of the TM fibrous layer, as the principal mechanism of progressive retraction. Hearing loss and tinnitus were the most consistently reported symptoms, present in roughly four-fifths to nine-tenths of patients in the largest Vietnamese endoscopic series, while otalgia and otorrhea were less frequent and more often associated with advanced-stage disease. Pure-tone audiometry, tympanometry, the seven-item Eustachian Tube Dysfunction Questionnaire, and temporal-bone computed tomography were the diagnostic tools most consistently used to stage disease and to plan management, with CT reported to identify the site of retraction with 91.9%–97.3% accuracy against surgical findings. For grade I–II atelectasis, watchful waiting and medical treatment directed at eustachian tube dysfunction were favored as first-line management, with surgery reserved for hearing loss exceeding roughly 30 dB or failure of conservative treatment after about six months. Surgical series, most reported for more advanced disease, showed consistent improvement in the air–bone gap and generally stable anatomic outcomes, although recurrence was concentrated in higher Sadé grades. Conclusions: Grade I–II tympanic membrane atelectasis is best managed through an evaluation sequence that combines otoendoscopic staging with audiometric, tympanometric, and eustachian tube function assessment, followed by staged escalation from observation and medical therapy to minimally invasive ventilation or reinforcement surgery when disease progresses. Vietnamese data, particularly from referral centres outside major cities, remain limited, and a structured cohort describing the clinical, paraclinical, and treatment-outcome profile of grade I–II disease would address a clear gap in the regional literature. Keywords: tympanic membrane atelectasis; retraction pocket; eustachian tube dysfunction; Sadé classification; cartilage tympanoplasty; ventilation tube; air–bone gap.