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We also analyzed the clinical characteristics associated with hearing outcomes in this cohort.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A total of 74 eligible patients were prospectively enrolled. Following myringotomy, middle ear lavage (MEL) samples underwent the CTP test to identify perilymph leakage. Intratympanic dexamethasone (IT-DEX) therapy was administered, and hearing outcomes were assessed. Control groups comprised patients with chronic otitis media (<jats:italic>n<\/jats:italic>\u2009=\u200940) and non-inflammatory middle ears (<jats:italic>n<\/jats:italic>\u2009=\u200951) with concurrent MEL sample collection.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>CTP was positive in 16 (22%) patients. No control samples showed positive results. Multiple regression analysis indicated that age and pre-treatment hearing levels significantly contributed to the CTP value. We found a positive correlation between CTP values, age, and pre-treatment pure-tone averages. Notably, CTP values in SSNHL cases aged 60 and above were significantly higher than in those below 60\u00a0years. Patients with positive CTP had significantly worse recovery rates after IT-DEX treatment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This study is the first prospective investigation demonstrating a positive relationship between CTP values, age, and hearing severity in SSNHL, indicating that PLF might be the essential cause of SSNHL, particularly in the elderly. Our findings suggest that IT-DEX may be less effective for PLF-associated SSNHL. Future research could reveal that PLF repair surgery is a viable treatment strategy for SSNHL. This study was registered under the UMIN Clinical Trials Registry (UMIN000010837) on 30\/May\/2013.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00405-023-08368-0","type":"journal-article","created":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T03:02:18Z","timestamp":1703127738000},"page":"2373-2381","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Prevalence of perilymphatic fistula in patients with sudden-onset sensorineural hearing loss as diagnosed by Cochlin-tomoprotein (CTP) biomarker detection: its association with age, hearing severity, and treatment outcomes"],"prefix":"10.1007","volume":"281","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8505-2960","authenticated-orcid":false,"given":"Akira","family":"Sasaki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6929-5084","authenticated-orcid":false,"given":"Tetsuo","family":"Ikezono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Matsuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuichiro","family":"Araki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Matsumura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiho","family":"Saitoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Wasano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Matsubara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,12,21]]},"reference":[{"key":"8368_CR1","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1056\/NEJMcp0802129","volume":"359","author":"SD Rauch","year":"2008","unstructured":"Rauch SD (2008) Clinical practice. 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This hCTP ELISA was developed in collaboration with IBL Inc. under license from (and with) the technical assistance of Saitama Medical University with royalties. This relationship did not influence the results of our study. All other authors have no competing interests to declare that are relevant to the content of this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of\u00a0 interest"}},{"value":"Approval was obtained from The Committee of Medical Ethics of Hirosaki University Graduate School of Medicine (2012-195) and Saitama Medical University (13-086). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Before undergoing any procedures, all participants provided written informed consent. For minors, consent was obtained from their guardians.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}