FRCS ORL-HNS Section 1 Practice Questions - Intercollegiate Specialty Fellowship Examination In Otolaryngology - Head And Neck Surgery (Section 1) Exam

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A 38-year-old woman presents with bilateral progressive hearing loss, worse in the right ear. She notes that her hearing improves slightly in noisy environments (paracusis Willisii). Otoscopy reveals normal tympanic membranes with a reddish hue visible through the right tympanic membrane (Schwartze sign). Pure tone audiometry shows a conductive hearing loss with a notch in bone conduction thresholds at 2 kHz (Carhart notch). What is the primary underlying pathological process?

Demineralization and bone remodeling of the otic capsule causing stapes fixation Keratin accumulation eroding the incudostapedial joint Autoimmune destruction of the inner ear hair cells Fibrosis and calcification of the tympanic membrane

Correct Answer:

Demineralization and bone remodeling of the otic capsule causing stapes fixation

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