Head and neck imaging: cholesteatoma on CT: practice question

A Radiology 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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Radiology · Head and neck imaging: cholesteatoma on CT

Sample item

A man with chronic foul ear discharge and conductive hearing loss has HRCT of the temporal bone showing a soft tissue mass in the epitympanum with erosion of the scutum and ossicles. What is the diagnosis?

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

The answer and the reasoning

A. Acquired cholesteatoma

A soft tissue mass in the attic with blunting of the scutum and ossicular erosion is typical of acquired cholesteatoma, which requires surgery. Otosclerosis causes fixation without a mass. Glomus tumours enhance and cause pulsatile tinnitus.

Option by option

  • A. Acquired cholesteatoma (correct)

    Correct. Attic mass with scutum erosion indicates cholesteatoma.

  • B. Otosclerosis

    Otosclerosis shows otospongiotic foci near the oval window.

  • C. Glomus tympanicum

    A glomus tympanicum is a vascular promontory mass with pulsatile tinnitus.

  • D. Acoustic schwannoma

    An acoustic schwannoma lies in the internal auditory 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 Radiology question

What is the answer to this Radiology question?

The best answer is A, Acquired cholesteatoma. A soft tissue mass in the attic with blunting of the scutum and ossicular erosion is typical of acquired cholesteatoma, which requires surgery.

Why is "Otosclerosis" not the answer?

Otosclerosis shows otospongiotic foci near the oval window.

Why is "Glomus tympanicum" not the answer?

A glomus tympanicum is a vascular promontory mass with pulsatile tinnitus.

Why is "Acoustic schwannoma" not the answer?

An acoustic schwannoma lies in the internal auditory canal.

What concept does this question test?

It tests Head and neck imaging: cholesteatoma on CT in Radiology. Otosclerosis causes fixation without a mass. Glomus tumours enhance and cause pulsatile tinnitus.

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 Head and neck imaging: cholesteatoma on CT?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.