Chronic Suppurative Otitis Media

A 32-year-old man from rural India presents with a 15-year history of chronic ear discharge and conductive hearing loss. Otoscopy reveals a large perforation of the tympanic membrane with mucopurulent discharge. Culture of the discharge grows Pseudomonas aeruginosa. What is the most common bacterial organism isolated in chronic suppurative otitis media with unsafe (atticoantral) disease?

A 32-year-old man with a 10-year history of ear discharge is evaluated for chronic suppurative otitis media (CSOM). Otoscopy reveals a central perforation with mucopurulent discharge. Which single clinical feature best distinguishes tubotympanic (safe) CSOM from atticantral (unsafe) CSOM?

Regarding the pathophysiology and clinical features of chronic suppurative otitis media (CSOM), all of the following are true EXCEPT:

A 32-year-old woman from rural Maharashtra presents with a 6-year history of foul-smelling purulent ear discharge, conductive hearing loss, and recurrent episodes of ear drainage. Otoscopy reveals a large attic perforation with granulation tissue. Regarding the management and complications of this condition, all of the following statements are correct EXCEPT:

A 28-year-old woman with a 10-year history of left ear discharge and hearing loss is found on CT temporal bone to have erosion of the stapes footplate and marginal perforation. Otoscopy shows granulation tissue at the perforation margin. She is afebrile with no vertigo. What is the most appropriate next step in management?