Facial palsy: 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 palsy

Sample item

A patient has a lower motor neurone facial palsy with loss of taste over the ipsilateral anterior two-thirds of the tongue. Stapedial reflex is intact, there is no hyperacusis and tear secretion is normal. Where is the lesion most likely located?

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

The answer and the reasoning

D. In the vertical segment, between the nerve to stapedius and the origin of the chorda tympani

Taste loss means the lesion lies proximal to where the chorda tympani leaves the nerve. Preserved stapedial reflex and lacrimation place it distal to the stapedius branch and geniculate ganglion. A lesion at the stylomastoid foramen spares taste.

Option by option

  • A. In the internal acoustic meatus

    An internal meatus lesion would add sensorineural hearing loss and vertigo.

  • B. At the stylomastoid foramen

    A lesion at the foramen is below the chorda origin, so taste would be preserved.

  • C. At the geniculate ganglion

    A geniculate lesion also causes hyperacusis and reduced lacrimation.

  • D. In the vertical segment, between the nerve to stapedius and the origin of the chorda tympani (correct)

    Correct. Taste is lost but stapedius function and lacrimation are preserved.

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, In the vertical segment, between the nerve to stapedius and the origin of the chorda tympani. Taste loss means the lesion lies proximal to where the chorda tympani leaves the nerve.

Why is "In the internal acoustic meatus" not the answer?

An internal meatus lesion would add sensorineural hearing loss and vertigo.

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

A lesion at the foramen is below the chorda origin, so taste would be preserved.

Why is "At the geniculate ganglion" not the answer?

A geniculate lesion also causes hyperacusis and reduced lacrimation.

What concept does this question test?

It tests Facial palsy in ENT. Preserved stapedial reflex and lacrimation place it distal to the stapedius branch and geniculate ganglion. A lesion at the stylomastoid foramen spares 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 palsy?

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.