Facial nerve: topodiagnosis: 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 · Facial nerve: topodiagnosis

Sample item

A patient with facial palsy has reduced tear secretion on Schirmer's test, loss of taste on the anterior tongue and an absent stapedial reflex. Where is the lesion?

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

The answer and the reasoning

B. At or proximal to the geniculate ganglion

Tear secretion depends on the greater petrosal nerve arising at the geniculate ganglion. Involvement of lacrimation, stapedius and taste places the lesion at or above the geniculate ganglion. Lesions distal to the chorda tympani spare lacrimation, reflex and taste.

Option by option

  • A. At the stylomastoid foramen

    A lesion at the stylomastoid foramen causes only motor palsy.

  • B. At or proximal to the geniculate ganglion (correct)

    Correct. Loss of lacrimation, reflex and taste places the lesion at or above the geniculate ganglion.

  • C. Between the stapedius branch and chorda tympani

    A lesion between stapedius and chorda spares lacrimation.

  • D. In the parotid gland

    Parotid lesions give only motor weakness.

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, At or proximal to the geniculate ganglion. Tear secretion depends on the greater petrosal nerve arising at the geniculate ganglion.

Why is "At the stylomastoid foramen" not the answer?

A lesion at the stylomastoid foramen causes only motor palsy.

Why is "Between the stapedius branch and chorda tympani" not the answer?

A lesion between stapedius and chorda spares lacrimation.

Why is "In the parotid gland" not the answer?

Parotid lesions give only motor weakness.

What concept does this question test?

It tests Facial nerve: topodiagnosis in ENT. Involvement of lacrimation, stapedius and taste places the lesion at or above the geniculate ganglion. Lesions distal to the chorda tympani spare lacrimation, reflex and taste.

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 Facial nerve: topodiagnosis?

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.