This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Ear, Subject name: ENT
[{'content': 'Middle ear infections are known to spread to the brain from all of the following routes except \nSelect and explain. \nA. Direct bony Invasion, B. Oval / Round window, C. Hematogenous spread, D. Lymphatic spread', 'role': 'user'}, {'content': 'Answer: D \nExplanation: Pathways of Spread of infection : Direct bone erosion Venous thrombophlebitis Preformed pathways Ref: Dhingra 7e pg 83.', 'role': 'assistant'}]