Otology: imaging 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: imaging of cholesteatoma

Sample item

On high-resolution CT of the temporal bone, which finding is typical of an attic cholesteatoma?

AHyperdense mass in the internal acoustic meatusBSoft tissue mass with blunting of the scutum and erosion of ossiclesCFluid level in the cochleaDEnlarged vestibular aqueduct

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

The answer and the reasoning

B. Soft tissue mass with blunting of the scutum and erosion of ossicles

HRCT shows a non-dependent soft tissue mass in the attic with erosion of the scutum, ossicles and sometimes the tegmen. Diffusion-weighted MRI helps in recurrence. Vestibular aqueduct and IAM lesions suggest other pathologies.

Option by option

A. Hyperdense mass in the internal acoustic meatus
An IAM mass suggests vestibular schwannoma.
B. Soft tissue mass with blunting of the scutum and erosion of ossicles (correct)
Correct. Soft tissue with scutum blunting and ossicular erosion indicates cholesteatoma.
C. Fluid level in the cochlea
A cochlear fluid level is not a feature of cholesteatoma.
D. Enlarged vestibular aqueduct
An enlarged aqueduct is a congenital inner ear anomaly.

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, Soft tissue mass with blunting of the scutum and erosion of ossicles. HRCT shows a non-dependent soft tissue mass in the attic with erosion of the scutum, ossicles and sometimes the tegmen.

Why is "Hyperdense mass in the internal acoustic meatus" not the answer?

An IAM mass suggests vestibular schwannoma.

Why is "Fluid level in the cochlea" not the answer?

A cochlear fluid level is not a feature of cholesteatoma.

Why is "Enlarged vestibular aqueduct" not the answer?

An enlarged aqueduct is a congenital inner ear anomaly.

What concept does this question test?

It tests Otology: imaging of cholesteatoma in ENT. Diffusion-weighted MRI helps in recurrence. Vestibular aqueduct and IAM lesions suggest other pathologies.

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: imaging 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.