A 31-year-old female patient complains of bilateral Impairment of hearing for the past 5 years. On examination, tympanic membrane (TM) is normal and audiogram shows a bilateral conductive loss. Impedance audiometry shows AS type of curve and absent acoustic reflex. All constitute part of treatment except:

In the above question, patient is a female with bilateral conductive hearing loss with normal tympanic membrane. Also the As curve indicates that compliance of tympanic membrane is restricted indicating ossicular fixation. Absence of stapedial reflex indicates that contraction of stapedius muscle is not producing any change in compliance of TM again indicating stapedial fixation. The diagnosis points to otosclerosis.Treatment of otosclerosis includes (a), (b) and (c). Gentamicin is never used. Gentamicin perfusion of the middle ear is used in Meniere's disease to selectively destroy vestibular end organs and to stop giddy attacks.