A study of five cases of suspected perilymphatic fistula treated with surgical repair

Abstract

We report five patients who underwent surgery and cochlin-tomoprotein (CTP) testing for suspected exolymphatic fistula in our department over an eight-month period. Triggers were identified in two cases, including one case of nasal biting (category 3) and one case of diving (category 2). CTP was negative in three cases and intermediate in two cases. Two cases showed leakage of extraglottic lymphatic fluid from the fossa rotunda. All four patients with vertigo showed improvement; hearing improved by > 10 dB in three cases. In category 4 cases, fluctuating hearing loss, fistula symptoms, and alternating directional nystagmus led to the suspicion of an exolymphatic fistula, and clinical findings of acute sensorineural hearing loss with dizziness should not be overlooked. Although the CTP test is minimally invasive, objective, and useful, the low positivity rate, the time required to obtain results (several weeks), and collection technique should be considered.