A-30-year old male is having Attic cholesteatoma of left ear with lateral sinus thromboplebitis. Which of the following will be the operation of choice –
**Core Concept**
The question requires knowledge of the management of attic cholesteatoma with lateral sinus thrombophlebitis. Attic cholesteatoma is a type of middle ear cystic lesion that can extend to the mastoid and lead to complications such as lateral sinus thrombophlebitis. The management of this condition involves surgical intervention to eradicate the cholesteatoma, repair any associated damage, and address the thrombophlebitis.
**Why the Correct Answer is Right**
The operation of choice in this scenario is a modified radical mastoidectomy with anticoagulation and antbiotics. This procedure involves the removal of the cholesteatoma, mastoidectomy, and exploration of the lateral sinus to remove any thrombus. Anticoagulation and antibiotics are used to prevent further clot formation and treat any associated infection. The goal of this procedure is to prevent further complications and promote healing.
**Why Each Wrong Option is Incorrect**
**Option A:** A simple mastoidectomy may not be sufficient to address the cholesteatoma and lateral sinus thrombophlebitis, and may lead to recurrence of the disease.
**Option B:** A radical mastoidectomy may be too aggressive for this case, and may result in significant hearing loss and facial nerve damage.
**Option C:** A tympanoplasty alone may not address the lateral sinus thrombophlebitis, and may not provide adequate access to the cholesteatoma.
**Clinical Pearl / High-Yield Fact**
In cases of attic cholesteatoma with lateral sinus thrombophlebitis, it is essential to address the thrombophlebitis promptly to prevent further complications, such as intracranial sepsis and cavernous sinus thrombosis.
**Correct Answer: C. Modified Radical Mastoidectomy**