A 4-year-old girl presents with ear pain and decreased hearing in her left ear. She has had three episodes of acute otitis media in the past six months. On examination, the left tympanic membrane appears scarred. What are the potential diagnoses, and what are the next steps?
This child's history of recurrent acute otitis media and findings of a scarred tympanic membrane suggest chronic suppurative otitis media (CSOM) or possibly tympanosclerosis. If it is CSOM, the child may require a prolonged course of antibiotics, along with regular cleaning of the ear by a healthcare professional. Tympanosclerosis involves calcification of the tympanic membrane following repeated infections and usually doesn't require specific treatment unless it significantly affects hearing. In any case, the child should be referred to an otolaryngologist for further management.