Transtympanic Electro-cochleography in the Assessment of Perilymphatic Fistulas

Sass, Kornel; Densert, Barbara; Magnusson, Måns

doi:10.1159/000259264

Cited by 7 publications

(4 citation statements)

References 14 publications

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“…20 Transtympanic electrocochleography showed a low sensitivity. 21,22 The present study revealed no false positive ␤-TP results. The mean value of ␤-TP in positive samples was 23.5 mg/l.…”

Section: Discussionsupporting

confidence: 46%

First clinical experience with β-trace protein (prostaglandin D synthase) as a marker for perilymphatic fistula

Michel¹,

Petereit²,

Klemm

et al. 2005

J. Laryngol. Otol.

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A diagnosis of perilymphatic fistula is still controversial. Recently, a case report indicated that beta-trace protein (prostaglandin D synthase) might be a potential marker for perilymphatic fluid. In this multicentre clinical case series study beta-trace protein was used as a marker for perilymphatic fluid fistula. Fifteen fluid samples were collected during diagnostic tympanoscopy. In addition, five samples were collected from patients with tympanic membrane perforation for use as as negative controls. Samples were obtained using precision glass capillaries and were analysed for beta-trace protein using laser nephelometry. The diagnosis of perilymphatic fistula was defined by the patient's history, the audiological and vestibular investigation and the findings at tympanoscopy. The cut-off level of beta-trace protein for perilymph-positive samples was chosen at 1.11 mg/l. The sensitivity and specificity were calculated using a 2 x 2 contingency table. There was no false positive result, but in two cases a false negative result was found. The specificity was 1 and the sensitivity was 0.81. The material of this first clinical study is small owing to the rarity of patients undergoing diagnostic tympanoscopy for perilymphatic fluid fistula. However, according to these preliminary results beta-trace protein might be a promising marker in the diagnosis of perilymphatic fluid fistulas.

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Section: Discussionsupporting

confidence: 46%

First clinical experience with β-trace protein (prostaglandin D synthase) as a marker for perilymphatic fistula

Michel¹,

Petereit²,

Klemm

et al. 2005

J. Laryngol. Otol.

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“…In animal models of meningitis, there is evidence that CSF changes early in the disease are transmitted to the inner ear and explain early hearing loss. 13 The close relationship between CSF and the inner ear fluid is well illustrated by perilymph fistula presenting with vertigo because of endolymphatic hydrops 14 15 and the rarer ‘stapes gusher’ recognised by ENT surgeons. A case showing imaging evidence of endolymphatic hydrops in spontaneous intracranial hypotension has been published.…”

Section: Relations Between Csf and The Inner Earmentioning

confidence: 99%

Orthostatic hearing loss: audiovestibular manifestations of spontaneous intracranial hypotension

et al. 2020

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A 36-year-old woman with severe postural headaches caused by spontaneous intracranial hypotension developed bilateral hearing loss. Her hearing loss varied in severity and also at times affected one ear more than the other. She noticed her hearing returned to normal on lying flat, and this was confirmed on audiometry. Her hearing fully recovered after treatment with blood patches. Audiovestibular symptoms affect up to 70% of people with spontaneous intracranial hypotension but are probably under-reported. Cerebrospinal fluid and inner ear fluids are related in two separate channels: the vestibular and the cochlear aqueducts. We discuss their role in the postural hearing loss of spontaneous intracranial hypotension.

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“…The decision is usually based on the clinical impression in combination with the standard diving decompression tables. One possibility for detecting a perilymphatic fistula preoperatively is the use of a transtympanic electrocochleography during raised intrathoracic pressure or with postural changes (12,13).…”

Section: Arterial Air Applicationmentioning

confidence: 99%

The Influence of an Arterial and Venous Air Embolism on the Hearing Level in Laboratory Mini Pigs

Juncker

1998

Acta Oto-Laryngologica

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We examined the influence of an experimental venous and arterial air embolism on the hearing level in laboratory mini pigs. Before and after the injection of air a threshold ABR was measured in anaesthetized mini pigs (n=15). A venous air embolism was performed in 6 animals: no changes in the hearing level or in the interpeak latencies Jewett wave V-I were observed in any of the animals before, during or after the application of air. In 9 animals the arterial embolism was done, 2 animals died and had to be excluded. In 6 animals out of 7 a hearing loss was observed starting after the injection of 40 ml air and finally ending in deafness for these 6 animals. The detected hearing loss is probably of cochlear origin, as no prolongations of the interpeak latencies of Jewett wave V-I at 90 dB HL were observed prior to the deafness. Our results show that air bubbles in the arterial circulation lead to cochlear damage ending in deafness. Our research indicates that decompression sickness, which is comparable to the arterial air embolism, is more often the cause of a sensorineural hearing loss after diving than previously believed.

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Transtympanic Electro-cochleography in the Assessment of Perilymphatic Fistulas

Cited by 7 publications

References 14 publications

First clinical experience with β-trace protein (prostaglandin D synthase) as a marker for perilymphatic fistula

First clinical experience with β-trace protein (prostaglandin D synthase) as a marker for perilymphatic fistula

Orthostatic hearing loss: audiovestibular manifestations of spontaneous intracranial hypotension

The Influence of an Arterial and Venous Air Embolism on the Hearing Level in Laboratory Mini Pigs

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