Ear and audiology: hemotympanum: 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 · Ear and audiology: hemotympanum

Sample item

After a fall on his head, a man has a dark blue bulging tympanic membrane with conductive hearing loss. The drum is intact and there is no discharge or facial weakness. What is the most appropriate initial approach?

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

The answer and the reasoning

A. Observation, as the blood usually resolves spontaneously

Blood in the middle ear after a head injury (hemotympanum) is a sign of a skull base injury and usually absorbs over weeks, with conductive loss recovering. Active surgery is not needed unless ossicular discontinuity, CSF leak or facial palsy appears. Follow with audiometry.

Option by option

  • A. Observation, as the blood usually resolves spontaneously (correct)

    Correct. Hemotympanum without discharge, leak or palsy is observed, and audiometry is repeated after resolution.

  • B. Tympanoplasty to rebuild the drum

    Tympanoplasty repairs a perforation or ossicular defect, and the drum here is intact.

  • C. Early cortical mastoidectomy

    Mastoidectomy treats coalescent mastoiditis or cholesteatoma, not post-traumatic blood.

  • D. Immediate myringotomy with grommet insertion

    Myringotomy is not needed and risks introducing infection into a blood-filled middle ear.

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 A, Observation, as the blood usually resolves spontaneously. Blood in the middle ear after a head injury (hemotympanum) is a sign of a skull base injury and usually absorbs over weeks, with conductive loss recovering.

Why is "Tympanoplasty to rebuild the drum" not the answer?

Tympanoplasty repairs a perforation or ossicular defect, and the drum here is intact.

Why is "Early cortical mastoidectomy" not the answer?

Mastoidectomy treats coalescent mastoiditis or cholesteatoma, not post-traumatic blood.

Why is "Immediate myringotomy with grommet insertion" not the answer?

Myringotomy is not needed and risks introducing infection into a blood-filled middle ear.

What concept does this question test?

It tests Ear and audiology: hemotympanum in ENT. Active surgery is not needed unless ossicular discontinuity, CSF leak or facial palsy appears. Follow with audiometry.

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 Ear and audiology: hemotympanum?

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.