Introduction: Based on clinical practice guidelines, the application of corticosteroids as a first-line therapy is common.Although sudden sensorineural hearing loss (SSHL) etiology is primarily idiopathic, hearing loss can result from a perilymphatic fistula (PLF).Recent findings show evidence of a specific rate of PLF based on a cochlin-tomoprotein (CTP) detection test.
Based on this rate of PLF treatment, the concepts of SSNHL need to be re-evaluated.The present study aimed to evaluate CTP in SSNHL patients and compare pre-surgical and post-surgical pure tone hearing thresholds after round and oval window sealing as first-line treatment.Material and Methods: A total of 30 patients with unilateral SSNHL with a pure tone average (PTA) (4 Freq.
of 60 dB or more were click here enrolled in a prospective study.All patients underwent tympanoscopy for middle ear exploration as a first-line treatment.After intraoperative observation of a possible PLF, all patients obtained middle ear lavage to gain CTP samples for following ELISA-based CTP detection tests.
All patients received round window and oval window sealing with fascia.PTA hearing thresholds were analyzed post-surgically 3 weeks after treatment based on 4-frequency bone conduction (BC).Results: The average preoperative pure tone BC threshold was 97.
7 dB compared with the 69 dB postoperative BC threshold.Mean BC improved by 20.3 dB after middle ear exploration and window sealing.
A total of 56% (17 of 30) of patients recovered at least 10 dB.The middle ear cochlin-tomoprotein detection rate was 70% positive.Conclusions: The combination of early tympanoscopy and inner ear-specific cochlin-tomoprotein as a detection tool for suspected PLF showed evidence of PLF as a key causative ilootpaperie in SSNHL.