Abstract
The detection of cochlin-tomoprotein (CTP) in the middle ear has been included in the revised Japanese diagnostic criteria for a definitive perilymph fistula (PLF). We have performed a retrospective study of six patients who were suspected to have PLF and underwent a CTP detection test by ELISA from December 2011 to January 2013 in our department. The CTP detection test had been performed from 11 days to one year after the onset of symptoms. Among these six patients, four patients were positive for CTP. One of the two patients whose chief complaint was dizziness was positive for CTP. Although this patient had a habit of nose blowing, she did not have any specific preceding events that might have triggered the PLF. The CTP detection test was extremely effective in this case for both making the diagnosis and deciding on the course of treatment. Three of four patients suffering from hearing loss and/or tinnitus were positive for CTP. In these three patients, the preceding events of the onset included sneezing, diving or head trauma. All four patients who showed positive test results had undergone an exploratory tympanotomy. The fistula was visually identified in only one of the four patients. It is expected that the CTP detection test will establish a new way to identify spontaneous PLF in the future.
