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ENT · Ear and audiology: CT in cochlear otosclerosis
Sample itemA 42-year-old woman with otosclerosis now has a mixed loss with a sensorineural component. High-resolution CT shows a band of reduced density encircling the cochlea. What is the radiological sign called?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Double ring sign
In retrofenestral otosclerosis, demineralised foci surround the cochlea, giving a second low-density ring around the cochlear turns, the double ring sign. The ice-cream cone is the MRI appearance of a vestibular schwannoma, and the Carhart notch is audiometric.
Option by option
A. Ice-cream cone sign
The ice-cream cone sign describes a schwannoma in the internal auditory canal and cerebellopontine angle.
B. Carhart notch
Carhart notch is a dip in bone conduction at 2 kHz on the audiogram, not a CT finding.
C. Double ring sign (correct)
Correct. A hypodense band encircling the cochlea is the double ring sign of cochlear otosclerosis.
D. Brown sign
Brown sign is the blanching of a red vascular middle ear mass on pneumatic otoscopy in a glomus tumour.
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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