Vestibular disorders: hearing-preserving schwannoma surgery: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Vestibular disorders: hearing-preserving schwannoma surgery

Sample item

A 40-year-old has a 7 mm intracanalicular vestibular schwannoma with good serviceable hearing and wants surgery rather than observation. Which approach can preserve hearing?

ARetrolabyrinthine vestibular nerve sectionBTranscochlear approachCTranslabyrinthine approachDMiddle cranial fossa approach

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Middle cranial fossa approach

The middle fossa approach gives access to the internal acoustic canal from above without opening the labyrinth, so cochlear function can be preserved in small lateral tumours. Retrosigmoid surgery can also preserve hearing. Translabyrinthine and transcochlear routes destroy the inner ear and are used when hearing is lost.

Option by option

A. Retrolabyrinthine vestibular nerve section
Vestibular nerve section treats vertigo and does not remove a tumour.
B. Transcochlear approach
The transcochlear route sacrifices the cochlea as well.
C. Translabyrinthine approach
The translabyrinthine route removes the labyrinth and ends hearing in that ear.
D. Middle cranial fossa approach (correct)
Correct. It reaches the canal above the labyrinth, sparing hearing in small tumours.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this ENT question

What is the answer to this ENT question?

The best answer is D, Middle cranial fossa approach. The middle fossa approach gives access to the internal acoustic canal from above without opening the labyrinth, so cochlear function can be preserved in small lateral tumours.

Why is "Retrolabyrinthine vestibular nerve section" not the answer?

Vestibular nerve section treats vertigo and does not remove a tumour.

Why is "Transcochlear approach" not the answer?

The transcochlear route sacrifices the cochlea as well.

Why is "Translabyrinthine approach" not the answer?

The translabyrinthine route removes the labyrinth and ends hearing in that ear.

What concept does this question test?

It tests Vestibular disorders: hearing-preserving schwannoma surgery in ENT. Retrosigmoid surgery can also preserve hearing. Translabyrinthine and transcochlear routes destroy the inner ear and are used when hearing is lost.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Vestibular disorders: hearing-preserving schwannoma surgery?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.