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EN4.{3-4,6-8,10-11,15} | Otitis Media and Middle Ear Surgery — Assignment

Grading Rubric — Otitis Media and Middle Ear Surgery — Assignment Rubric

Criterion	Points	Full-marks descriptor
EN4.6 & EN4.7 — CSOM Classification and Clinical Reasoning	8 pts	Exceeds: Correctly identifies both cases as tubotympanic (safe) vs atticoantral (unsafe) CSOM with all discriminating features (perforation site, cholesteatoma, discharge character, bone erosion); accurately explains the surgical management rationale for each; correctly states the key safety distinction (no cholesteatoma = safe; cholesteatoma = unsafe, requires mastoidectomy)
EN4.3 & EN4.4 — ASOM and OME Management (including myringotomy site)	6 pts	Exceeds: Correctly stages ASOM and justifies the decision for or against myringotomy; names the anteroinferior quadrant precisely with the anatomical reason; correctly sequences OME management (watchful waiting 3 months before surgery); identifies correct grommet/tympanoplasty indications
EN4.8 & EN4.11 — CSOM Complications and Mastoidectomy	4 pts	Exceeds: Correctly identifies the intracranial complication from the clinical picture; names 3 intracranial and 2 extracranial complications of CSOM; explains the principle of mastoidectomy as disease eradication (not hearing improvement) for unsafe CSOM
Quality of Clinical Reasoning and Communication	2 pts	Exceeds: Structured, logically sequenced responses; correct ENT terminology used throughout; answers address all sub-questions concisely with clinical rationale clearly linked to the case