Otology Q12

A 35-year-old man presents to his GP unwell with severe otalgia and otorrhoea for the past week along with an increasing hearing loss and fever. On examination, there is tenderness and swelling behind the pinna; the tympanic membrane has a small central perforation and there is a profuse creamy discharge present within the canal. He is sent to hospital for IV antibiotics but remains unwell two days later with protrusion of the pinna and retro-auricular erythema.

What is the most appropriate management?

  • A) MRI Head
  • B) Myringotomy and tympanostomy tube (grommet) insertion
  • C) CT Head
  • D) Continue IV antibiotics for 2 weeks before re-assessing
  • E) Cortical mastoidectomy