Treatment of choice for CSOM with vertigo and facial nerve palsy is:

(c) Immediate mastoid exploration(Ref. Shambaugh, 6th ed., 448)This is an unsafe CSOM. Here cholesteatoma eroding fallopian canal and causing fistula formation on the medial wall of middle ear (lateral semicircular canal, promontory, oval window) is causing facial nerve palsy and vertigo respectively. So the management is immediate mastoid exploration to remove cholesteatoma.