A 35-year-old man presents with progressive unilateral conductive hearing loss, absent stapedial reflex on the affected side, and a normal tympanic membrane on otoscopy. Tuning fork tests show Rinne negative and Weber lateralising to the affected ear. Which ossicular chain abnormality is most consistent with this picture?
- A Ossicular discontinuity due to incus necrosis
- B Malleus head fixation in the epitympanum
- C Otosclerosis with stapes fixation at the footplate ✓
- D Tympanosclerosis of the round window
Correct answer: C. Otosclerosis with stapes fixation at the footplate
Explanation
Otosclerosis classically presents with progressive conductive hearing loss in young adults with a normal, pearly white tympanic membrane. The absent stapedial reflex reflects stapes fixation at the oval window footplate. Tympanometry typically shows an As (stiff) curve. Rinne negative with Weber to the affected ear confirms unilateral conductive loss.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.