1.

Conductive hearing impairment occurs with large exostoses of the external

auditory canal when E
a. Debris prevents normal tympanic membrane vibration
b. Narrowing of the external auditory canal reaches 5 mm
c. Narrowing of the external auditory canal reaches 2 mm
d. All of the above
e. a and c

2. Osteonecrosis of the tympanic bone presents with bone exposure in the

external auditory canal and may be associated with E
a. Radiation history to the temporal bone
b. Lupus vasculitis
c. Diabetes
d. a and b
e. All of the above

3. The most common malignancy of the temporal bone is D

a. Adenoid cystic carcinoma
b. Pleomorphic adenoma
c. Warthin’s tumor
d. Squamous carcinoma
e. Ceruminoma

4. The mechanism for salivary gland tumor involvement of the temporal bone
is A
a. Direct extension
b. Hematogenous metastases
c. Ectopic salivary rests within the temporal bone
d. Squamous metaplasia
e. Absence of the fissures of Santorini

5. A fungating mass of the external auditory canal is biopsied in the office. The
pathologist reports acute and chronic inflammation. The next step in
management is B
a. Consult infectious disease
b. Image and rebiopsy
c. Lateral temporal bone resection
d. Subtotal temporal bone resection
e. Radiation therapy

6. The best study to distinguish postoperative scar from tumor recurrence is A

a. PET-CT imaging
b. PET imaging
c. CT
d. MRI with contrast
e. MRI-CT fusion imaging
7. The most significant prediction of postoperative survival in temporal bone
carcinoma is B
a. Preoperative chemotherapy and radiation
b. Clear surgical margins
c. Postoperative chemotherapy and radiation
d. Patient age
e. Extensiveness of resection

8. Advanced malignancies of the temporal bone are best treated with C

a. Surgery only
b. Radiation only
c. Surgery and radiation
d. Chemotherapy

9. Radiologic assessment of temporal bone malignancies may include

a. CT scan
b. MRI
c. Cerebral angiography
d. All of the above

10. Which of the following does not contribute to the closing of the lumen of
the Eustachian tube? D
a. Coiling properties of the cartilaginous skeleton
b. Active contraction of the associated muscles
c. Pressure of tissues neighboring the lumen
d. All of the above

11. Which are the most common symptoms of the patulous Eustachian tube? C
a. Autophony made worse in recumbent position
b. Autophony and pressure-induced dizziness
c. Aural fullness and autophony
d. Symptoms associated with retraction and atelectasis of the tympanic
membrane

12. Diagnosis of patulous Eustachian tube is certain with D

a. Appropriate findings on axial CT
b. Appropriate findings on sonotubometry
c. Presence of typical symptoms
d. Observation of lateral and medical excursions of the drum

13. Which of the following is not normally found as part of the

pathophysiology of chronic suppurative otitis media? C
a. Capillary proliferation
b. Rarefying osteitis
c. Multinucleated giant cells
d. New bone formation
e. Granulation tissue
14. Which of the following statements is true of fat graft tympanoplasty? C
a. Donor fat is usually harvested from the abdomen.
b. Fat graft tympanoplasties do not require rimming of the perforation.
c. The literature justifies performing this procedure bilaterally and
simultaneously.
d. It is an important technique for perforations involving 75% of the tympanic
membrane or less.
e. It is appropriate for any patient with a tympanic membrane perforation and a
hearing loss of 50 dB or less

15. Cartilage should be considered as a graft material in the following

situations: E
a. The atelectatic ear
b. Cholesteatoma
c. A perforation anterior to the annulus
d. A perforation larger than 50%
e. All of the above

16. The following are true statements concerning the perichondrium/cartilage

island flap except D
a. A strip of cartilage 1–2 mm in width is removed to facilitate the malleus.
b. The graft is placed as an underlay graft, medial to the malleus.
c. Tragal cartilage is most suitable for total tympanic membrane reconstruction.
d. One should expect a cosmetic defect after harvest in the tragal area.
e. The graft is placed so that the perichondrium side is out, toward the canal

17. The most common presentation of cerebrospinal fluid

(CSF) leak in the temporal bone is A
a. Middle ear effusion
b. Otorrhea
c. Meningitis
d. Seizure
e. Mass in the ear canal

18. Confirmation of spinal fluid in the ear is best made with which test? C
a. Glucose content
b. Protein content
c. β-2 transferrin
d. CT
e. MRI

19. Possible risks and complications of stapedectomy surgery include E

a. Worsened hearing
b. Tinnitus
c. Dizziness
d. Taste disturbance
e. All of the above
20. Studies have shown the following may produce sensorineural
hearing loss following stapedotomy: E
a. Viral infection
b. Blood in the inner ear
c. Gusher
d. Otosclerosis
e. All of the above