<prompt> Treatment of middle ear malignancy includes -a Excision of petrous part of temporal boneb Subcortical excisionc Modified radical mastoidectomyd Noneabcbcacbcd  <response>: Most common malignant tumor of middle ear and mastoid is squamous cell carcinoma.Clinical FeaturesIt affects age group 4060 yearsSlightly more common in femalesMost important predisposing cause is long standing CSOMPatient may present with chronic foul smelling blood stained dischargePain is severe and comes at night.Facial palsy may be seenOE Friable, hemorrhagic granulation or polyp are present.Diagnosis made only on biopsyCT and angiography are done to see the extent of disease.Metastasis occurs to cervical lymph nodes later.Treatment of carcinoma of middle ear is combination of surgery followed by radiotherapy.Surgery consists of radical mastoidectomy subtotal or total petrosectomy depending on the extent of tumor. 