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 -
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.
Topical antibiotics and decongestants for 4 weeks
IV antibiotics and follow up after a month
Tympanoplasty
Tympano-mastoid exploration