Audiology: stapedial reflex: 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 · Audiology: stapedial reflex

Sample item

A patient with a lower motor neurone facial palsy has an absent ipsilateral stapedial reflex on impedance audiometry. What does this indicate?

AThe lesion is in the parotid glandBThe lesion is proximal to the origin of the nerve to stapediusCThe lesion is at the stylomastoid foramenDThe lesion involves only the temporal branch

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

The answer and the reasoning

B. The lesion is proximal to the origin of the nerve to stapedius

The nerve to stapedius arises in the descending (mastoid) segment of the facial nerve. An absent reflex therefore places the lesion at or above that point, such as in the temporal bone. A lesion at the stylomastoid foramen or in the parotid spares the reflex.

Option by option

A. The lesion is in the parotid gland
Parotid lesions are distal to the stapedius branch.
B. The lesion is proximal to the origin of the nerve to stapedius (correct)
Correct. Absence of the reflex localises the lesion proximal to the stapedius branch.
C. The lesion is at the stylomastoid foramen
A lesion at the stylomastoid foramen lies distal to the stapedius branch, so the reflex is preserved.
D. The lesion involves only the temporal branch
A peripheral branch lesion would not affect the stapedius.

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 B, The lesion is proximal to the origin of the nerve to stapedius. The nerve to stapedius arises in the descending (mastoid) segment of the facial nerve.

Why is "The lesion is in the parotid gland" not the answer?

Parotid lesions are distal to the stapedius branch.

Why is "The lesion is at the stylomastoid foramen" not the answer?

A lesion at the stylomastoid foramen lies distal to the stapedius branch, so the reflex is preserved.

Why is "The lesion involves only the temporal branch" not the answer?

A peripheral branch lesion would not affect the stapedius.

What concept does this question test?

It tests Audiology: stapedial reflex in ENT. An absent reflex therefore places the lesion at or above that point, such as in the temporal bone. A lesion at the stylomastoid foramen or in the parotid spares the reflex.

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 Audiology: stapedial reflex?

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.