Vestibular disorders: translabyrinthine approach: 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: translabyrinthine approach

Sample item

A 2 cm vestibular schwannoma is to be removed in a patient whose hearing on that side is already non-serviceable. The surgeon wants early identification of the facial nerve at the fundus and minimal cerebellar retraction. Which approach is best?

AMiddle cranial fossa approachBRetrosigmoid approachCTranscochlear approachDTranslabyrinthine approach

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

The answer and the reasoning

D. Translabyrinthine approach

The translabyrinthine route removes the mastoid and labyrinth, giving wide access to the internal auditory canal and cerebellopontine angle with minimal cerebellar retraction and early facial nerve identification, but it sacrifices hearing. It is therefore chosen when hearing is already lost. The middle fossa route is limited to small intracanalicular tumours with good hearing.

Option by option

A. Middle cranial fossa approach
The middle cranial fossa approach is used for small tumours confined to the canal when hearing is to be preserved.
B. Retrosigmoid approach
The retrosigmoid approach involves more cerebellar retraction and is usually chosen when hearing preservation is attempted.
C. Transcochlear approach
The transcochlear approach removes the cochlea and facial nerve rerouting is needed, which is more extensive than required.
D. Translabyrinthine approach (correct)
Correct. It gives lateral to medial facial nerve identification and sacrifices only non-serviceable hearing.

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, Translabyrinthine approach. The translabyrinthine route removes the mastoid and labyrinth, giving wide access to the internal auditory canal and cerebellopontine angle with minimal cerebellar retraction and early facial nerve identification, but it sacrifices hearing.

Why is "Middle cranial fossa approach" not the answer?

The middle cranial fossa approach is used for small tumours confined to the canal when hearing is to be preserved.

Why is "Retrosigmoid approach" not the answer?

The retrosigmoid approach involves more cerebellar retraction and is usually chosen when hearing preservation is attempted.

Why is "Transcochlear approach" not the answer?

The transcochlear approach removes the cochlea and facial nerve rerouting is needed, which is more extensive than required.

What concept does this question test?

It tests Vestibular disorders: translabyrinthine approach in ENT. It is therefore chosen when hearing is already lost. The middle fossa route is limited to small intracanalicular tumours with good hearing.

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: translabyrinthine approach?

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.