Which of the following is a well-accepted contraindication to stapes surgery for otosclerosis?

• A Schwartze sign over the promontory
• B Conductive loss of 25 dB with air-bone gap of 15 dB
• C Mixed hearing loss with 20 dB sensorineural component
• D The operated ear being the only hearing ear ✓

Explanation

Operating on the only hearing ear risks a dead ear, so it is a standard contraindication; hearing aid fitting is preferred. A small air-bone gap below about 20 dB generally does not justify surgery because expected gain cannot be achieved, making option B a relative reason to defer rather than the classic contraindication tested. Schwartze sign indicates active disease but is not an absolute bar.

Reference: Diseases of Ear, Nose and Throat, Dhingra, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.