A 12-year-old female with persistent left-sided ear discharge and hearing loss has an intact TM with peripheral granulation. What is the diagnosis?

The presence of persistent left-sided ear discharge and hearing loss, combined with an intact tympanic membrane (TM) exhibiting peripheral granulation, is indicative of a cholesteatoma. Cholesteatoma is characterized by the accumulation of skin cells and other debris in the middle ear and can lead to both conductive hearing loss and infection.

In this scenario, the intact TM suggests that there is no perforation, and the presence of granulation tissue points towards chronic inflammation commonly associated with cholesteatoma. This condition can occur as a result of chronic ear infections or poorly functioning Eustachian tubes, leading to the accumulation of epithelial cells in the ear.

Cholesteatomas can also cause subsequent complications, such as erosion of surrounding structures, which may result in further hearing loss or other complications. Early diagnosis and treatment are important to prevent these complications.

Other conditions listed may present with some overlapping symptoms, but they do not fit the specific combination of an intact TM with peripheral granulation and persistent discharge as clearly as cholesteatoma does.