Ear and audiology: Hitselberger sign in vestibular schwannoma: 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 · Ear and audiology: Hitselberger sign in vestibular schwannoma

Sample item

A 48-year-old woman has progressive right sensorineural hearing loss with tinnitus and poor speech discrimination. While examining the ear, light touch on the posterosuperior part of the right bony canal feels numb to her. Which lesion best explains the findings?

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

The answer and the reasoning

A. Large vestibular schwannoma compressing the nervus intermedius

The nervus intermedius carries sensation from a patch of skin of the posterosuperior canal wall and concha. A large cerebellopontine angle tumour compresses it, giving hypoaesthesia there (Hitselberger sign). It signals a retrocochlear lesion of substantial size.

Option by option

  • A. Large vestibular schwannoma compressing the nervus intermedius (correct)

    Correct. Numbness of this canal patch points to nervus intermedius compression by a large cerebellopontine angle tumour.

  • B. Glomus tympanicum arising on the promontory

    A glomus tympanicum gives pulsatile tinnitus and a red retrotympanic mass, not skin numbness.

  • C. Cholesteatoma eroding the lateral semicircular canal

    Cholesteatoma gives discharge, a retraction pocket and a fistula sign, not canal wall numbness with poor discrimination.

  • D. Otosclerosis with a stapes footplate focus

    Otosclerosis causes conductive loss with a normal canal and no sensory change.

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, Large vestibular schwannoma compressing the nervus intermedius. The nervus intermedius carries sensation from a patch of skin of the posterosuperior canal wall and concha.

Why is "Glomus tympanicum arising on the promontory" not the answer?

A glomus tympanicum gives pulsatile tinnitus and a red retrotympanic mass, not skin numbness.

Why is "Cholesteatoma eroding the lateral semicircular canal" not the answer?

Cholesteatoma gives discharge, a retraction pocket and a fistula sign, not canal wall numbness with poor discrimination.

Why is "Otosclerosis with a stapes footplate focus" not the answer?

Otosclerosis causes conductive loss with a normal canal and no sensory change.

What concept does this question test?

It tests Ear and audiology: Hitselberger sign in vestibular schwannoma in ENT. A large cerebellopontine angle tumour compresses it, giving hypoaesthesia there (Hitselberger sign). It signals a retrocochlear lesion of substantial size.

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 Ear and audiology: Hitselberger sign in vestibular schwannoma?

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.