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Cholesteatoma Intracranial Complications — SCE Infectious Diseases MCQ

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ModerateRespiratory InfectionCholesteatoma Intracranial ComplicationsSCE Infectious Diseases

An adult has months of unilateral foul-smelling otorrhoea, progressive conductive hearing loss and an attic retraction pocket containing keratin debris. What is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: DArrange expedited ENT assessment and audiological evaluation for suspected cholesteatoma

Persistent unilateral otorrhoea, conductive hearing loss and an attic keratin pocket are concerning for cholesteatoma, which can erode local structures and requires specialist assessment. Repeated empirical antibiotics may temporarily suppress discharge but do not remove the lesion. Irrigation is inappropriate when the tympanic membrane and middle ear may be involved.

Reference: NICE NG98: Hearing loss in adults: https://www.nice.org.uk/guidance/ng98/chapter/recommendations