A 22-year-old woman has inactive mucosal CSOM with a dry central perforation of the pars tensa and a 30 dB conductive hearing loss. The middle ear mucosa is healthy and the mastoid is well pneumatised on CT. The most appropriate definitive management is:

• A Long-term topical antibiotic drops alone
• B Modified radical mastoidectomy
• C Radical mastoidectomy
• D Myringoplasty with temporalis fascia graft ✓

Explanation

An inactive ear with a dry central perforation, healthy mucosa, and no cholesteatoma requires closure of the defect to restore hearing and prevent recurrent infection, achieved by myringoplasty using temporalis fascia, the standard graft material. Modified radical and radical mastoidectomy are destructive operations reserved for unsafe ears with cholesteatoma or irreversible disease. Topical drops control active infection but cannot close a permanent perforation and are not definitive treatment for a dry ear.

Reference: Dhingra's Diseases of Ear, Nose and Throat, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.