Frontiers in neurology · 2025
Fluctuating or progressive hearing loss in the middle-to-high frequencies may suggest the neurotologic endotype of perilymphatic fistula without antecedent traumatic events.
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Matsuda Han, Maeda Yukihide, Kitahara Tomoyasu, Sawada Masafumi, Kudo Hiroe, Sakamoto Kei, Takayama Atsuya, Ikezono Tetsuo
Аннотация
BACKGROUND: Idiopathic sudden sensorineural hearing loss (ISSNHL) is a common clinical condition. Recent studies indicate that approximately 20% of ISSNHL cases may involve perilymphatic fistula (PLF). The detection of Cochlin-tomoprotein (CTP) in middle-ear lavage samples confirms the diagnosis of PLF.
AIMS/OBJECTIVES: To clarify the clinical characteristics of inner ear-related symptoms in patients with PLF who lacked any antecedent traumatic events prior to symptom onset.
MATERIALS AND METHODS: We retrospectively reviewed clinical records and CTP test results in 769 cases from 70 hospitals in Japan.
RESULTS: Among these cases, 204 had no history of antecedent events. CTP-positive findings were more frequently observed in patients exhibiting fluctuating and/or progressive hearing loss than in those without these symptoms (p < 0.05, Fisher's exact test). The odds of a positive CTP test did not differ between patients with and without vestibular symptoms, nystagmus, a fistula sign, a popping sensation, or streaming water-like tinnitus (p > 0.05, Fisher's exact test). The CTP positivity rate was highest in patients with a high-frequency sloping audiogram.
CONCLUSIONS AND SIGNIFICANCE: Fluctuating or progressive hearing loss in the middle-to-high frequencies may reasonably suggest PLF in the absence of antecedent traumatic events.
AIMS/OBJECTIVES: To clarify the clinical characteristics of inner ear-related symptoms in patients with PLF who lacked any antecedent traumatic events prior to symptom onset.
MATERIALS AND METHODS: We retrospectively reviewed clinical records and CTP test results in 769 cases from 70 hospitals in Japan.
RESULTS: Among these cases, 204 had no history of antecedent events. CTP-positive findings were more frequently observed in patients exhibiting fluctuating and/or progressive hearing loss than in those without these symptoms (p < 0.05, Fisher's exact test). The odds of a positive CTP test did not differ between patients with and without vestibular symptoms, nystagmus, a fistula sign, a popping sensation, or streaming water-like tinnitus (p > 0.05, Fisher's exact test). The CTP positivity rate was highest in patients with a high-frequency sloping audiogram.
CONCLUSIONS AND SIGNIFICANCE: Fluctuating or progressive hearing loss in the middle-to-high frequencies may reasonably suggest PLF in the absence of antecedent traumatic events.