Conclusion: Approximately 50% of patients with sPLF based on the clinical diagnosis criteria were definitively diagnosed with CTP-positive sPLF. These results suggest that early surgery within 7 days of the disease onset contributes to improvements in the therapeutic response of hearing loss.
Objectives/hypothesis: Idiopathic spontaneous perilymph fistula (sPLF) cannot be diagnosed reliably. It is speculated that this condition occurs in patients with vertigo-accompanied acute sensorineural hearing loss that progresses rapidly in spite of steroid therapy. This study herein evaluated cochlin-tomoprotein (CTP) test results in patients with sPLF who underwent exploratory tympanotomy and considered surgical outcomes with true sPLF.
Study design: Retrospective study.
Methods: Twenty-three patients diagnosed with sPLF based on the clinical diagnosis criteria who underwent exploratory tympanotomy were included.
Results: CTP test results were positive in 11 cases. In CTP-positive cases, the mean hearing level was 66.5 dB pre-operatively and 42.3 dB post-operatively. The hearing level post-operatively completely recovered in four cases, markedly recovered in three cases, slightly recovered in one case and showed no response in three cases. Hearing level improvements were significantly better in CTP-positive patients who underwent surgery within 7 days of the disease onset than in those treated 8 or more days after the disease onset.
Keywords: CTP; exploratory tympanotomy; idiopathic spontaneous perilymph fistula; sudden sensorineural hearing loss.