Han Matsuda1, Kei Sakamoto1, Tomohiro Matsumura2, Shiho Saito2, Susumu Shindo1, Kunihiro Fukushima3, Shin-Ya Nishio4, Ryosuke Kitoh4, Osamu Shibasaki5, Akinori Ito5, Ryuichiro Araki6, Shin-Ichi Usami4, Mamoru Suzuki7, Kaoru Ogawa8, Tomonori Hasegawa9, Yoshiaki Hagiwara10, Yasuhiro Kase1, Tetsuo Ikezono1. 1. a Department of Otorhinolaryngology , Saitama Medical University , Moroyama , Japan. 2. b Department of Biochemistry and Molecular Biology , Nippon Medical School , Tokyo , Japan. 3. c Shin Kurashiki ENT Clinic , Okayama , Japan. 4. d Department of Otorhinolaryngology , Shinshu University School of Medicine , Matsumoto , Japan. 5. e Division of Neuro-Otology, Department of Otolaryngology , Saitama Medical University , Moroyama , Japan. 6. f Community Health Science Center, Saitama Medical University , Moroyama , Japan. 7. g Department of Otolaryngology , Tokyo Medical University , Tokyo , Japan. 8. h Department of Otorhinolaryngology Head and Neck Surgery , Keio University School of Medicine , Tokyo , Japan. 9. i SRL, Inc. , Tokyo , Japan. 10. j IBL Co., Ltd. (Immuno-Biological Laboratories, Co., Ltd.) , Fujioka , Japan.
Abstract
OBJECTIVE: To investigate the positive rate for the Cochlin tomo-protein (CTP: an inner ear-specific protein) detection test among patients with inner ear-related clinical manifestations and evaluate the clinical characteristics of definite perilymphatic fistula (PLF). METHODS: We have performed an ELISA-based CTP detection test using middle ear lavage (MEL) samples from 497 cases of suspected PLF enrolled from 70 clinical centers nationwide between 2014 and 2015. In addition to the CTP-positive rate, audio-vestibular symptoms were compared between CTP-positive and -negative cases. RESULTS: 8-50% of patients in category 1 (trauma, middle and inner ear disease cases), and about 20% of those in categories 2, 3 and 4 (external origin antecedent events, internal origin antecedent events, and without antecedent event, respectively) were positive for CTP. In category 1 cases, the earlier tested samples showed a higher CTP-positive rate, whereas no differences were observed in categories 2, 3 or 4. The characteristic clinical features in the earlier tested cases were nystagmus and fistula sign in CTP test-positive cases in category 1, and streaming water-like tinnitus in those in categories 2, 3 and 4. CONCLUSION: The present study clarified that CTP detection test-positive patients exist at considerable rates among patients with inner ear-related manifestations.
OBJECTIVE: To investigate the positive rate for the Cochlin tomo-protein (CTP: an inner ear-specific protein) detection test among patients with inner ear-related clinical manifestations and evaluate the clinical characteristics of definite perilymphatic fistula (PLF). METHODS: We have performed an ELISA-based CTP detection test using middle ear lavage (MEL) samples from 497 cases of suspected PLF enrolled from 70 clinical centers nationwide between 2014 and 2015. In addition to the CTP-positive rate, audio-vestibular symptoms were compared between CTP-positive and -negative cases. RESULTS: 8-50% of patients in category 1 (trauma, middle and inner ear disease cases), and about 20% of those in categories 2, 3 and 4 (external origin antecedent events, internal origin antecedent events, and without antecedent event, respectively) were positive for CTP. In category 1 cases, the earlier tested samples showed a higher CTP-positive rate, whereas no differences were observed in categories 2, 3 or 4. The characteristic clinical features in the earlier tested cases were nystagmus and fistula sign in CTP test-positive cases in category 1, and streaming water-like tinnitus in those in categories 2, 3 and 4. CONCLUSION: The present study clarified that CTP detection test-positive patients exist at considerable rates among patients with inner ear-related manifestations.