Ear and audiology: perilymph gusher: 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: perilymph gusher

Sample item

A boy with mixed hearing loss and a family history of X-linked deafness undergoes stapes surgery. After the footplate is opened, a copious flow of clear fluid wells up. What is the cause?

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

The answer and the reasoning

B. Wide cochlear aqueduct and widened internal auditory canal link the CSF and perilymph

In X-linked mixed deafness due to POU3F4 mutation, a bulbous internal acoustic meatus with a deficient lateral fundus plate allows CSF to flow into the perilymph. When the footplate is opened, a perilymph gusher results. Stapes surgery is contraindicated in these children.

Option by option

  • A. Cholesteatoma erosion

    Cholesteatoma erosion produces fistulae, not a gusher.

  • B. Wide cochlear aqueduct and widened internal auditory canal link the CSF and perilymph (correct)

    Correct. CSF pressure is transmitted through the open channels.

  • C. Facial nerve dehiscence

    Facial dehiscence causes nerve exposure, not fluid flow.

  • D. Eustachian tube reflux

    Tubal reflux does not generate fluid under pressure.

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.

More ENT questions

Questions about this ENT question

What is the answer to this ENT question?

The best answer is B, Wide cochlear aqueduct and widened internal auditory canal link the CSF and perilymph. In X-linked mixed deafness due to POU3F4 mutation, a bulbous internal acoustic meatus with a deficient lateral fundus plate allows CSF to flow into the perilymph.

Why is "Cholesteatoma erosion" not the answer?

Cholesteatoma erosion produces fistulae, not a gusher.

Why is "Facial nerve dehiscence" not the answer?

Facial dehiscence causes nerve exposure, not fluid flow.

Why is "Eustachian tube reflux" not the answer?

Tubal reflux does not generate fluid under pressure.

What concept does this question test?

It tests Ear and audiology: perilymph gusher in ENT. When the footplate is opened, a perilymph gusher results. Stapes surgery is contraindicated in these children.

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: perilymph gusher?

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.