Vestibular disorders: stereotactic radiosurgery for schwannoma: 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.

Try it

ENT · Vestibular disorders: stereotactic radiosurgery for schwannoma

Sample item

A 76-year-old with ischaemic heart disease has a vestibular schwannoma of 2 cm that has grown on two consecutive MRI scans. He is unfit for open surgery. What is the most suitable treatment?

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

The answer and the reasoning

C. Stereotactic radiosurgery

Stereotactic radiosurgery (for example gamma knife) is an effective option for small to medium vestibular schwannomas in patients who are elderly or unfit for surgery, aiming to arrest growth. Continued observation is for stable or very small tumours. Open approaches are unsuitable given his cardiac risk.

Option by option

  • A. Translabyrinthine excision

    A translabyrinthine excision is major surgery and is not suitable for an unfit patient.

  • B. Retrosigmoid decompression

    A retrosigmoid operation is also open posterior fossa surgery with the same anaesthetic risk.

  • C. Stereotactic radiosurgery (correct)

    Correct. Radiosurgery controls growth of a small to medium growing tumour without an open operation.

  • D. Further annual MRI observation

    Observation alone is not appropriate when the tumour has shown documented growth.

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 C, Stereotactic radiosurgery. Stereotactic radiosurgery (for example gamma knife) is an effective option for small to medium vestibular schwannomas in patients who are elderly or unfit for surgery, aiming to arrest growth.

Why is "Translabyrinthine excision" not the answer?

A translabyrinthine excision is major surgery and is not suitable for an unfit patient.

Why is "Retrosigmoid decompression" not the answer?

A retrosigmoid operation is also open posterior fossa surgery with the same anaesthetic risk.

Why is "Further annual MRI observation" not the answer?

Observation alone is not appropriate when the tumour has shown documented growth.

What concept does this question test?

It tests Vestibular disorders: stereotactic radiosurgery for schwannoma in ENT. Continued observation is for stable or very small tumours. Open approaches are unsuitable given his cardiac risk.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Vestibular disorders: stereotactic radiosurgery for schwannoma?

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.