Ear and audiology: glomus jugulare lower cranial nerve syndrome: 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: glomus jugulare lower cranial nerve syndrome

Sample item

A 52-year-old woman has pulsatile tinnitus, a reddish retrotympanic mass, hoarseness and difficulty swallowing with deviation of the tongue. CT shows moth-eaten erosion of the jugular foramen. Which diagnosis explains the cranial nerve palsies?

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

The answer and the reasoning

A. Glomus jugulare tumour extending through the jugular foramen

A glomus jugulare arises in the jugular bulb adventitia and erodes the jugular foramen, involving cranial nerves IX, X and XI, and later XII through the hypoglossal canal. Glomus tympanicum stays on the promontory and gives pulsatile tinnitus and conductive loss without these palsies.

Option by option

  • A. Glomus jugulare tumour extending through the jugular foramen (correct)

    Correct. Foraminal erosion explains the lower cranial nerve palsies.

  • B. Cholesteatoma of the attic

    Cholesteatoma does not give a pulsatile vascular mass.

  • C. Acoustic neuroma in the cerebellopontine angle

    A cerebellopontine angle tumour affects V, VII and VIII, not X and XII as early features.

  • D. Glomus tympanicum confined to the promontory

    Glomus tympanicum is limited to the middle ear and does not cause cranial nerve palsies.

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, Glomus jugulare tumour extending through the jugular foramen. A glomus jugulare arises in the jugular bulb adventitia and erodes the jugular foramen, involving cranial nerves IX, X and XI, and later XII through the hypoglossal canal.

Why is "Cholesteatoma of the attic" not the answer?

Cholesteatoma does not give a pulsatile vascular mass.

Why is "Acoustic neuroma in the cerebellopontine angle" not the answer?

A cerebellopontine angle tumour affects V, VII and VIII, not X and XII as early features.

Why is "Glomus tympanicum confined to the promontory" not the answer?

Glomus tympanicum is limited to the middle ear and does not cause cranial nerve palsies.

What concept does this question test?

It tests Ear and audiology: glomus jugulare lower cranial nerve syndrome in ENT. Glomus tympanicum stays on the promontory and gives pulsatile tinnitus and conductive loss without these palsies.

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: glomus jugulare lower cranial nerve syndrome?

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.