Ear and audiology: first branchial cleft anomaly: 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: first branchial cleft anomaly

Sample item

A 6-year-old has a recurrent infected swelling just below the earlobe near the angle of the mandible. Pus intermittently drains into the external auditory canal. Which structure is most at risk during excision?

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

The answer and the reasoning

D. Facial nerve

First branchial cleft anomalies lie in or near the parotid and pass close to the facial nerve and the external canal. The facial nerve is therefore at risk, and excision should be done with nerve monitoring. A second cleft fistula instead tracks between the carotid arteries toward the tonsillar fossa.

Option by option

  • A. Glossopharyngeal nerve

    The glossopharyngeal nerve is crossed by second cleft fistulae deep in the neck.

  • B. Hypoglossal nerve

    The hypoglossal nerve is related to second cleft remnants and the carotid bifurcation, not the ear canal.

  • C. Spinal accessory nerve

    The spinal accessory nerve lies in the posterior triangle and is not the structure at risk here.

  • D. Facial nerve (correct)

    Correct. First cleft tracks run in relation to the parotid and facial nerve and the external canal.

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 D, Facial nerve. First branchial cleft anomalies lie in or near the parotid and pass close to the facial nerve and the external canal.

Why is "Glossopharyngeal nerve" not the answer?

The glossopharyngeal nerve is crossed by second cleft fistulae deep in the neck.

Why is "Hypoglossal nerve" not the answer?

The hypoglossal nerve is related to second cleft remnants and the carotid bifurcation, not the ear canal.

Why is "Spinal accessory nerve" not the answer?

The spinal accessory nerve lies in the posterior triangle and is not the structure at risk here.

What concept does this question test?

It tests Ear and audiology: first branchial cleft anomaly in ENT. The facial nerve is therefore at risk, and excision should be done with nerve monitoring. A second cleft fistula instead tracks between the carotid arteries toward the tonsillar fossa.

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: first branchial cleft anomaly?

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.