A child presents with ear infection with foul smelling discharge. On further exploration a small perforation is found in the pars flaccida of the tympanic membrance. Most appropriate next step in the management would be -
Topical antibiotics and decongestants for 4 weeks
IV antibiotics and follow up after a month
Tympanoplasty
Tympano-mastoid exploration
Child presenting with foul smelling discharge with perforation in the pars flaccida of the tympanic membrane suggests unsafe CSOM.
Conservative management is not of much help in these cases; surgery is the mainstay of treatment.
Tympano mastoid exploration is the ideal option in such cases.

Tympano-mastiod exploration can be done through various procedures:

––Canal wall down procedures: Atticotomy, and rarely radical mastoidectomy.
––Canal wall up procedures: Cortical mastoidectomy
Preferred treatment would be
ALSO KNOW
Recounstruction of hearing mechanism by tympanoplasty is only the second priority.