Pg Blazer - Online Test Series 31 - Ent

Brainstem Evoked Response Audiometry (BERA) is the investigation of choice in assessing hearing loss in neonates. This test measures the electrical activity of the auditory nerve and brainstem in response to sound stimuli. It is particularly useful in newborns as it can provide objective information about their hearing abilities, even if they are unable to respond behaviorally. BERA can help identify the type and degree of hearing loss, which is crucial for early intervention and management of hearing impairment in neonates. Impedance audiometry, free field audiometry, and behavioral audiometry may also be used in assessing hearing loss, but BERA is considered the most reliable and accurate method in this population.

The correct answer is Adenoidectomy with grommet insertion. Adenoidectomy is the surgical removal of the adenoids, which are lymphoid tissues located at the back of the nasal cavity. In a 6 year old child with recurrent upper respiratory tract infections (URTI), mouth breathing, and failure to grow, the adenoids may be enlarged and causing obstruction of the airway. Adenoidectomy can help improve airflow and alleviate symptoms. Grommet insertion involves placing small tubes in the eardrums to help drain fluid from the middle ear, which can be beneficial in cases of impaired hearing. Therefore, adenoidectomy with grommet insertion is the appropriate treatment choice in this scenario.

Aspergillus spp is the most common etiological agent in paranasal sinus mycoses. This is because Aspergillus species are ubiquitous in the environment and can easily colonize the sinuses. They are commonly found in decaying organic matter and can be inhaled, leading to sinus infections. Aspergillus spp are known to cause a variety of sinus-related symptoms such as nasal congestion, facial pain, and sinusitis. They can also cause more severe infections in immunocompromised individuals.

Hyperacusis in Bell's palsy is due to the paralysis of the stapedius muscle. The stapedius muscle is responsible for dampening the sound vibrations that enter the inner ear through the stapes bone. When this muscle is paralyzed, it is unable to properly regulate the intensity of sound, leading to hyperacusis, which is an increased sensitivity to loud noises.

Malignant otitis externa is an infection, not a malignancy. Hence no mitotic figures are found.

Attic cholesteatoma is an indication for modified radical mastoidectomy. (Canal wall down mastoidectomy)

Ossicular disruption with intact tympanic membrane causes an average hearing loss of 54 dB.

The patient should first undergo laryngectomy and then receive post-operative radiotherapy. This is because the case involves carcinoma larynx with the involvement of the anterior commissure and right vocal cord, as well as perichondritis of the thyroid cartilage. Laryngectomy is the surgical removal of the larynx, which is the most appropriate treatment for advanced laryngeal cancer. Post-operative radiotherapy is recommended to target any remaining tumor cells and improve the chances of long-term disease control.

Features of Ménière’s disease are:
Aural fullness
Fluctuating sensorineural deafness
Fluctuating tinnitus
Episodic vertigo

If the postero superior retraction pocket is allowed to progress, it can cause sensori neural hearing loss. Sensori neural hearing loss refers to a type of hearing loss that occurs due to damage to the inner ear or the auditory nerve. In the case of a postero superior retraction pocket, the pocket can cause pressure on the delicate structures of the inner ear, leading to damage and subsequent hearing loss. Therefore, if the condition is not addressed and allowed to progress, it can result in sensori neural hearing loss.