Ear and audiology: facial nerve 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: facial nerve schwannoma

Sample item

A 35-year-old man has facial weakness that progressed over eight months with no recovery, after earlier twitching. Otoscopy is normal. CT shows smooth enlargement of the geniculate ganglion region of the facial canal. What is the most likely diagnosis?

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

The answer and the reasoning

A. Facial nerve schwannoma

Facial palsy that is slowly progressive, does not recover within about four months, or follows twitching should raise suspicion of a facial nerve tumour. CT shows smooth expansion of the fallopian canal, commonly around the geniculate ganglion. Bell palsy usually begins abruptly and improves.

Option by option

  • A. Facial nerve schwannoma (correct)

    Correct. Slow progression without recovery and smooth canal expansion indicate a facial nerve schwannoma.

  • B. Bell palsy

    Bell palsy has an abrupt onset with recovery in most patients, and imaging is normal.

  • C. Malignant otitis externa

    Malignant otitis externa is a painful diabetic infection with otorrhoea and granulations, with canal erosion rather than smooth expansion.

  • D. Ramsay Hunt syndrome

    Ramsay Hunt syndrome has painful vesicles and a rapid onset.

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, Facial nerve schwannoma. Facial palsy that is slowly progressive, does not recover within about four months, or follows twitching should raise suspicion of a facial nerve tumour.

Why is "Bell palsy" not the answer?

Bell palsy has an abrupt onset with recovery in most patients, and imaging is normal.

Why is "Malignant otitis externa" not the answer?

Malignant otitis externa is a painful diabetic infection with otorrhoea and granulations, with canal erosion rather than smooth expansion.

Why is "Ramsay Hunt syndrome" not the answer?

Ramsay Hunt syndrome has painful vesicles and a rapid onset.

What concept does this question test?

It tests Ear and audiology: facial nerve schwannoma in ENT. CT shows smooth expansion of the fallopian canal, commonly around the geniculate ganglion. Bell palsy usually begins abruptly and improves.

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: facial nerve 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.