Nose and paranasal sinuses: medial rectus injury at sinus surgery: 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 · Nose and paranasal sinuses: medial rectus injury at sinus surgery

Sample item

After endoscopic ethmoidectomy, a patient has double vision. The right eye cannot move toward the nose, and the diplopia is worst on looking left. Which structure was most likely injured?

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

The answer and the reasoning

D. Right medial rectus through the lamina papyracea

The lamina papyracea is the thin medial orbital wall next to the ethmoids. A breach can injure the medial rectus, causing limited adduction and horizontal diplopia. Immediate or early repair is considered, and orbital imaging is needed.

Option by option

  • A. Right optic nerve

    Optic nerve injury would cause visual loss and not an isolated adduction deficit.

  • B. Right lateral rectus

    The lateral rectus abducts the eye and is not related to the ethmoid wall.

  • C. Right superior oblique

    The superior oblique is injured by trochlear damage at the superomedial orbit and causes vertical diplopia.

  • D. Right medial rectus through the lamina papyracea (correct)

    Correct. Limited adduction after ethmoid surgery points to medial rectus injury through the lamina papyracea.

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 D, Right medial rectus through the lamina papyracea. The lamina papyracea is the thin medial orbital wall next to the ethmoids.

Why is "Right optic nerve" not the answer?

Optic nerve injury would cause visual loss and not an isolated adduction deficit.

Why is "Right lateral rectus" not the answer?

The lateral rectus abducts the eye and is not related to the ethmoid wall.

Why is "Right superior oblique" not the answer?

The superior oblique is injured by trochlear damage at the superomedial orbit and causes vertical diplopia.

What concept does this question test?

It tests Nose and paranasal sinuses: medial rectus injury at sinus surgery in ENT. A breach can injure the medial rectus, causing limited adduction and horizontal diplopia. Immediate or early repair is considered, and orbital imaging is needed.

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 Nose and paranasal sinuses: medial rectus injury at sinus surgery?

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.