<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 4-year-old boy is brought to a pediatrician with a history of repeated episodes of right-ear symptoms, including irritability, fever, ear pain, and pulling at the ear, for the last 2 years. Each episode has been treated with an appropriate antibiotic for the recommended duration of time as prescribed by the pediatrician. The boy had experienced 3 episodes during his 3rd year of life and 5 episodes during the last year; the last episode occurred 2 months ago. There is no history of recurrent rhinosinusitis or nasal obstruction. On physical examination, vital signs are stable. Otoscopic examination of the right ear reveals a white tympanic membrane with decreased mobility. There is no erythema or bulging of the tympanic membrane. Which of the following interventions is most likely to be considered for further management of this child?? A: Antibiotic prophylaxis with subtherapeutic dose of sulfonamide, B: Oral corticosteroids for 2 weeks, C: Adenoidectomy, D: Myringotomy without insertion of a tympanostomy tube, E: Myringotomy with insertion of a tympanostomy tube,  <response>: This is a clinical case scenario about a 4-year-old boy with recurrent episodes of right ear symptoms suggestive of acute otitis media. The key findings are:- Repeated episodes of right ear pain, fever, irritability, ear pulling over the past 2 years - 3 episodes in 3rd year of life, 5 episodes in 4th year of life- Treated with appropriate antibiotics each time- No history of rhinosinusitis or nasal obstruction - Otoscopic exam shows white tympanic membrane with decreased mobility, no erythema or bulgingThis history of recurrent acute otitis media without nasalsinus disease suggests eustachian tube dysfunction leading to inadequate aeration of the middle ear space. The whitish, immobile tympanic membrane indicates fluid collection behind the ear drum. The options include antibiotic prophylaxis, oral steroids, adenoidectomy, myringotomy without tube, and myringotomy with tube insertion. Since this is a case of persistent middle ear effusion, the most appropriate next step would be myringotomy with insertion of a tympanostomy tube to allow drainage and ventilation of the middle ear space.E: Myringotomy with insertion of a tympanostomy tube 