A 56-year-old gentleman presents to his GP with long-standing left-sided otorrhoea. He has not previously sought help as he felt embarrassed at the foul smell of the discharge. On otoscopy there is retraction of the superior aspect of the left tympanic membrane, alongside which a brown crust-like mass is seen. Tuning fork tests reveal a slight conductive hearing loss despite the patient not reporting this in the history.
What is the most appropriate first step in the management of this patient?
- A) Hearing aids
- B) Pure tone audiogram
- C) MRI scan
- D) Tympanoplasty
- E) Tympanomastoidectomy
ASCENT 