Ear and audiology: DWI MRI after cholesteatoma surgery: 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: DWI MRI after cholesteatoma surgery

Sample item

A patient who had canal wall up mastoidectomy for cholesteatoma 18 months ago has an unremarkable-looking drum. The surgeon wants to exclude residual disease without re-operating. Which investigation is most suitable?

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

The answer and the reasoning

B. Non-echo-planar diffusion-weighted MRI, where cholesteatoma appears hyperintense

Canal wall up surgery can leave hidden disease behind an intact drum. Non-echo-planar diffusion-weighted MRI shows keratin as a bright restricted-diffusion lesion and reduces the need for second-look surgery. CT cannot separate soft tissue types.

Option by option

  • A. Tympanometry

    Tympanometry does not detect hidden cholesteatoma.

  • B. Non-echo-planar diffusion-weighted MRI, where cholesteatoma appears hyperintense (correct)

    Correct. Restricted diffusion makes keratin bright on DWI.

  • C. Plain mastoid X-ray

    Plain films lack soft-tissue detail.

  • D. Audiometry alone

    Audiometry shows function, not residual disease.

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 B, Non-echo-planar diffusion-weighted MRI, where cholesteatoma appears hyperintense. Canal wall up surgery can leave hidden disease behind an intact drum.

Why is "Tympanometry" not the answer?

Tympanometry does not detect hidden cholesteatoma.

Why is "Plain mastoid X-ray" not the answer?

Plain films lack soft-tissue detail.

Why is "Audiometry alone" not the answer?

Audiometry shows function, not residual disease.

What concept does this question test?

It tests Ear and audiology: DWI MRI after cholesteatoma surgery in ENT. Non-echo-planar diffusion-weighted MRI shows keratin as a bright restricted-diffusion lesion and reduces the need for second-look surgery. CT cannot separate soft tissue types.

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: DWI MRI after cholesteatoma surgery?

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.