Ear and audiology: facial palsy in acute otitis media: 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 palsy in acute otitis media

Sample item

A 5-year-old with a red bulging tympanic membrane and fever develops right lower motor neuron facial palsy over a day. What is the most appropriate management?

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

The answer and the reasoning

C. Intravenous antibiotics with myringotomy

Facial palsy in acute otitis media is usually due to inflammation of a nerve in a dehiscent canal. Intravenous antibiotics with myringotomy to drain the pus usually allow full recovery. Surgery on the nerve is not first-line.

Option by option

  • A. Oral prednisolone alone

    Steroids alone do not treat the infection that is causing the nerve injury.

  • B. Immediate facial nerve decompression

    Decompression is reserved for failure of treatment, not first-line in an acute infection.

  • C. Intravenous antibiotics with myringotomy (correct)

    Correct. Treat the infection with intravenous antibiotics and drain the middle ear by myringotomy.

  • D. Observation and review in two weeks

    Observation risks progression of an untreated suppurative focus near the nerve.

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, Intravenous antibiotics with myringotomy. Facial palsy in acute otitis media is usually due to inflammation of a nerve in a dehiscent canal.

Why is "Oral prednisolone alone" not the answer?

Steroids alone do not treat the infection that is causing the nerve injury.

Why is "Immediate facial nerve decompression" not the answer?

Decompression is reserved for failure of treatment, not first-line in an acute infection.

Why is "Observation and review in two weeks" not the answer?

Observation risks progression of an untreated suppurative focus near the nerve.

What concept does this question test?

It tests Ear and audiology: facial palsy in acute otitis media in ENT. Intravenous antibiotics with myringotomy to drain the pus usually allow full recovery. Surgery on the nerve is not first-line.

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 palsy in acute otitis media?

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.