Head and neck oncology: 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 · Head and neck oncology

Sample item

A 60-year-old smoker has hoarseness for six weeks. Laryngoscopy shows a small lesion on the mobile true vocal fold and no palpable neck nodes. Which anatomical feature best explains why such tumours rarely spread to nodes early?

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

The answer and the reasoning

A. The glottis has very sparse lymphatic drainage

Glottic tumours present early because even a small lesion alters voice, and the true cords have very few lymphatics. Nodal spread is therefore uncommon in early disease, giving high cure rates with radiotherapy or limited surgery. Supraglottic tumours drain richly to the neck nodes and tend to present later.

Option by option

  • A. The glottis has very sparse lymphatic drainage (correct)

    Correct. Few lymphatics and early hoarseness give early-stage, node-negative disease.

  • B. The glottis is separated from the supraglottis by a cartilage barrier

    The glottis is not walled off by cartilage; spread depends on lymphatic density, not a cartilage barrier.

  • C. The glottis drains directly into the thoracic duct

    The larynx drains to deep cervical nodes, not directly to the thoracic duct.

  • D. The vocal fold has a rich capillary plexus that traps tumour cells

    Blood capillaries do not trap tumour cells and prevent lymphatic spread.

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, The glottis has very sparse lymphatic drainage. Glottic tumours present early because even a small lesion alters voice, and the true cords have very few lymphatics.

Why is "The glottis is separated from the supraglottis by a cartilage barrier" not the answer?

The glottis is not walled off by cartilage; spread depends on lymphatic density, not a cartilage barrier.

Why is "The glottis drains directly into the thoracic duct" not the answer?

The larynx drains to deep cervical nodes, not directly to the thoracic duct.

Why is "The vocal fold has a rich capillary plexus that traps tumour cells" not the answer?

Blood capillaries do not trap tumour cells and prevent lymphatic spread.

What concept does this question test?

It tests Head and neck oncology in ENT. Nodal spread is therefore uncommon in early disease, giving high cure rates with radiotherapy or limited surgery. Supraglottic tumours drain richly to the neck nodes and tend to present later.

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 oncology?

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.