Otology: theory of cholesteatoma: 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: theory of cholesteatoma

Sample item

Which theory best explains the commonest type of acquired cholesteatoma in the attic?

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

The answer and the reasoning

C. Invagination of a retraction pocket of the pars flaccida

Negative middle ear pressure from tubal dysfunction draws the pars flaccida inward, forming a retraction pocket whose keratin cannot clear. This is the most widely accepted theory. Congenital cholesteatoma arises from embryonic epithelial rests.

Option by option

  • A. Epithelial rests from embryonic life

    Embryonic rests explain congenital cholesteatoma.

  • B. Metaplasia of middle ear mucosa

    Metaplasia is a less accepted theory.

  • C. Invagination of a retraction pocket of the pars flaccida (correct)

    Correct. Retraction pocket invagination is the commonest mechanism.

  • D. Basal cell hyperplasia only

    Basal cell hyperplasia describes the papillary ingrowth theory, a minor theory.

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 C, Invagination of a retraction pocket of the pars flaccida. Negative middle ear pressure from tubal dysfunction draws the pars flaccida inward, forming a retraction pocket whose keratin cannot clear.

Why is "Epithelial rests from embryonic life" not the answer?

Embryonic rests explain congenital cholesteatoma.

Why is "Metaplasia of middle ear mucosa" not the answer?

Metaplasia is a less accepted theory.

Why is "Basal cell hyperplasia only" not the answer?

Basal cell hyperplasia describes the papillary ingrowth theory, a minor theory.

What concept does this question test?

It tests Otology: theory of cholesteatoma in ENT. This is the most widely accepted theory. Congenital cholesteatoma arises from embryonic epithelial rests.

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: theory of cholesteatoma?

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.