A girl for chronic ear discharge, pain on ocular movements and veigo underwent mastoidectomy. There was no relief post-operatively and continuous purulent ear discharge was seen. Patient also had sensorineural hearing loss. The most probable diagnosis would he:
**Core Concept**
The underlying condition being tested involves complications of otitis media, specifically those that can lead to persistent ear discharge, pain, and neurological symptoms like vertigo, alongside sensorineural hearing loss. This scenario suggests an infection or inflammatory process that has spread beyond the middle ear.
**Why the Correct Answer is Right**
Given the symptoms of chronic ear discharge, pain on ocular movements, vertigo, and the lack of relief post-mastoidectomy, along with sensorineural hearing loss, the most probable diagnosis would involve a condition that affects both the middle and inner ear, potentially involving the central nervous system. This presentation is highly suggestive of **lateral sinus thrombosis** or another complication of otitis media that has not been adequately addressed by mastoidectomy alone.
**Why Each Wrong Option is Incorrect**
**Option A:** Would be incorrect as it doesn't account for the complexity of symptoms presented, especially the neurological ones.
**Option B:** Similarly, would not fully explain the range of symptoms, particularly the sensorineural hearing loss.
**Option C:** Might seem plausible but doesn't fully align with the combination of otological and neurological symptoms described.
**Option D:** Is not provided, but based on the clinical presentation, any option not considering the spread of infection or inflammation beyond the middle ear would be incorrect.
**Clinical Pearl / High-Yield Fact**
A key point to remember is that complications of otitis media, such as lateral sinus thrombosis, can present with a combination of otological and neurological symptoms. The presence of sensorineural hearing loss alongside chronic discharge and vertigo should prompt consideration of such complications.
**Correct Answer:** D. Lateral sinus thrombosis.