Chronic Suppurative Otitis Media

A 28-year-old man from rural Maharashtra presents with a 6-month history of foul-smelling purulent discharge from the left ear following an episode of acute otitis media 8 months ago. He reports conductive hearing loss and occasional ear pain. Otoscopy reveals a large central perforation with granulation tissue and polyps in the external auditory canal. Pure tone audiometry shows air-bone gap of 35 dB. High-resolution CT temporal bone shows erosion of the ossicles and sclerotic mastoid bone. Which of the following is the most appropriate next step in management?

In chronic suppurative otitis media, which ossicle is most commonly eroded due to osteitis?

A 32-year-old man presents with a 10-year history of chronic suppurative otitis media with active drainage from the ear canal. Otoscopy reveals a central perforation with mucopurulent discharge. He has no fever and no complications. What is the drug of choice for topical management of the active infection?

A 32-year-old man presents with a 10-year history of foul-smelling otorrhoea from the left ear, conductive hearing loss, and recurrent ear discharge despite topical antibiotics. On otoscopy, a large perforation is seen with granulation tissue and polyps in the external auditory canal. Which investigation is most appropriate to assess the extent of bone erosion and guide surgical planning?

A 28-year-old woman with a 5-year history of chronic ear discharge and conductive hearing loss is being evaluated for possible cholesteatoma. Otoscopy shows a retraction pocket with foul-smelling discharge and granulation tissue. Which investigation is most specific for confirming the diagnosis of cholesteatoma?