This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: ENT
[{'content': '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 - \nSelect and explain. \nA. Topical antibiotics and decongestants for 4 weeks, B. IV antibiotics and follow up after a month, C. Tympanoplasty, D. Tympano-mastoid exploration', 'role': 'user'}, {'content': 'Answer: D \nExplanation: Child presenting with foul smelling discharge with perforation in the pars flaccida of the tympanic membrane suggests unsafe CSOM.\nConservative management is not of much help in these cases; surgery is the mainstay of treatment.\nTympano mastoid exploration is the ideal option in such cases.\n\nTympano-mastiod exploration can be done through various procedures:\n\n––Canal wall down procedures: Atticotomy, and rarely radical mastoidectomy.\n––Canal wall up procedures: Cortical mastoidectomy\nPreferred treatment would be\nALSO KNOW\nRecounstruction of hearing mechanism by tympanoplasty is only the second priority.', 'role': 'assistant'}]