Abstract
Answer C. Refer for surgical excision
The clinical picture is suggestive of cholesteatoma. Although it has no malignant potential, cholesteatoma can be locally destructive. It should be removed surgically to prevent further erosions and infections. Suspected cholesteatomas ought to be referred urgently for consultant review in clinic.
InnovAiT article: Hearing loss: Conductive versus sensorineural. DOI: 10.1177/17557380211070030.