Otology: aerotitis media: 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 · Otology: aerotitis media

Sample item

A passenger has severe ear pain, fullness and hearing loss during aircraft descent. The drum is retracted with some congestion. What is the underlying mechanism?

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

The answer and the reasoning

A. Failure of the eustachian tube to equalise pressure, leaving negative middle ear pressure

During descent the ambient pressure rises and the eustachian tube may fail to open, causing negative middle ear pressure, retraction and sometimes haemotympanum. Management includes decongestants, the Valsalva or Toynbee manoeuvre and treating nasal congestion.

Option by option

  • A. Failure of the eustachian tube to equalise pressure, leaving negative middle ear pressure (correct)

    Correct. Tubal failure leads to negative middle ear pressure.

  • B. Rupture of the round window membrane only

    Round window rupture is a separate complication.

  • C. Viral labyrinthitis

    Labyrinthitis is not caused by pressure changes in this way.

  • D. Direct rupture of the ossicular chain

    Ossicular disruption is a rare outcome, not the mechanism.

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.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is A, Failure of the eustachian tube to equalise pressure, leaving negative middle ear pressure. During descent the ambient pressure rises and the eustachian tube may fail to open, causing negative middle ear pressure, retraction and sometimes haemotympanum.

Why is "Rupture of the round window membrane only" not the answer?

Round window rupture is a separate complication.

Why is "Viral labyrinthitis" not the answer?

Labyrinthitis is not caused by pressure changes in this way.

Why is "Direct rupture of the ossicular chain" not the answer?

Ossicular disruption is a rare outcome, not the mechanism.

What concept does this question test?

It tests Otology: aerotitis media in ENT. Management includes decongestants, the Valsalva or Toynbee manoeuvre and treating nasal congestion.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Otology: aerotitis media?

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.