{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:06:22Z","timestamp":1787843182749,"version":"build-2784847793"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Idiopathic sudden sensorineural hearing loss (ISSNHL) is a common clinical condition. Recent studies indicate that approximately 20% of ISSNHL cases may involve perilymphatic fistula (PLF). The detection of Cochlin-tomoprotein (CTP) in middle-ear lavage samples confirms the diagnosis of PLF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims\/Objectives<\/jats:title><jats:p>To clarify the clinical characteristics of inner ear\u2013related symptoms in patients with PLF who lacked any antecedent traumatic events prior to symptom onset.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>We retrospectively reviewed clinical records and CTP test results in 769 cases from 70 hospitals in Japan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among these cases, 204 had no history of antecedent events. CTP-positive findings were more frequently observed in patients exhibiting fluctuating and\/or progressive hearing loss than in those without these symptoms (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05, Fisher\u2019s exact test). The odds of a positive CTP test did not differ between patients with and without vestibular symptoms, nystagmus, a fistula sign, a popping sensation, or streaming water\u2013like tinnitus (<jats:italic>p<\/jats:italic>\u202f&amp;gt;\u202f0.05, Fisher\u2019s exact test). The CTP positivity rate was highest in patients with a high-frequency sloping audiogram.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and significance<\/jats:title><jats:p>Fluctuating or progressive hearing loss in the middle-to-high frequencies may reasonably suggest PLF in the absence of antecedent traumatic events.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1571379","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T04:10:36Z","timestamp":1744603836000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Fluctuating or progressive hearing loss in the middle-to-high frequencies may suggest the neurotologic endotype of perilymphatic fistula without antecedent traumatic events"],"prefix":"10.3389","volume":"16","author":[{"given":"Han","family":"Matsuda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukihide","family":"Maeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyasu","family":"Kitahara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masafumi","family":"Sawada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroe","family":"Kudo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Sakamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuya","family":"Takayama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuo","family":"Ikezono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1288\/00005537-198601000-00007","article-title":"Perilymph fistula: the Iowa experience","volume":"96","author":"Seltzer","year":"1986","journal-title":"Laryngoscope"},{"key":"ref2","first-page":"254","article-title":"Surgical management of perilymphatic fistulas: a Portland experience","volume":"13","author":"Black","year":"1992","journal-title":"Am J Otol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1269298","DOI":"10.3389\/fneur.2023.1269298","article-title":"Assessing the efficacy of perilymphatic fistula repair surgery in alleviating vestibular symptoms and associated auditory impairments","volume":"14","author":"Matsuda","year":"2023","journal-title":"Front Neurol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e0191498","DOI":"10.1371\/journal.pone.0191498","article-title":"The diagnostic performance of a novel ELISA for human CTP (Cochlin-tomoprotein) to detect perilymph leakage","volume":"13","author":"Ikezono","year":"2018","journal-title":"PLoS One"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1158","DOI":"10.3109\/00016489.2014.919406","article-title":"Idiopathic sudden sensorineural hearing loss in Japan","volume":"134","author":"Nakashima","year":"2014","journal-title":"Acta Otolaryngol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1002\/lary.26133","article-title":"Quality of life and hearing eight years after sudden sensorineural hearing loss","volume":"127","author":"H\u00e4rk\u00f6nen","year":"2017","journal-title":"Laryngoscope"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2373","DOI":"10.1007\/s00405-023-08368-0","article-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","volume":"281","author":"Sasaki","year":"2024","journal-title":"Eur Arch Otorrinolaringol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"S53","DOI":"10.1080\/00016489.2017.1300940","article-title":"A nationwide multicenter study of the Cochlin Tomo-protein detection test: clinical characteristics of perilymphatic fistula cases","volume":"137","author":"Matsuda","year":"2017","journal-title":"Acta Otolaryngol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.3389\/fneur.2020.01046","article-title":"Perilymphatic fistula: a review of classification, etiology, diagnosis, and treatment","volume":"11","author":"Sarna","year":"2020","journal-title":"Front Neurol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1080\/14992020802441799","article-title":"Audiometric shape and presbycusis","volume":"48","author":"Demeester","year":"2009","journal-title":"Int J Audiol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"874971","DOI":"10.3389\/fsurg.2022.874971","article-title":"Consensus on MR imaging of endolymphatic Hydrops in patients with suspected hydropic ear disease (Meniere)","volume":"9","author":"Liu","year":"2022","journal-title":"Front Surg"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1159\/000490268","article-title":"Imaging of temporal bone","volume":"82","author":"Pyykk\u00f6","year":"2019","journal-title":"Adv Otorhinolaryngol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.anl.2017.02.002","article-title":"Imaging of the endolymphatic space in patients with Meniere's disease","volume":"45","author":"Yoshida","year":"2018","journal-title":"Auris Nasus Larynx"},{"key":"ref14","first-page":"469","article-title":"Endolymphatic hydrops in perilymphatic fistula","volume":"103","author":"Nomura","year":"1987","journal-title":"Acta Otolaryngol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"68","DOI":"10.3109\/00016488809125080","article-title":"Audiological aspects of idiopathic perilymphatic fistula","volume":"456","author":"Fukaya","year":"1988","journal-title":"Acta Otolaryngol Suppl"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/S0030-6665(20)30397-2","article-title":"Update on idiopathic perilymphatic fistulas","volume":"29","author":"Kohut","year":"1996","journal-title":"Otolaryngol Clin N Am"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1097\/MAO.0000000000000928","article-title":"Longitudinal cognitive and neurobehavioral functional outcomes before and after repairing Otic capsule dehiscence","volume":"37","author":"Wackym","year":"2016","journal-title":"Otol Neurotol"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1571379\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T04:10:38Z","timestamp":1744603838000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1571379\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,14]]},"references-count":17,"alternative-id":["10.3389\/fneur.2025.1571379"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1571379","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,14]]},"article-number":"1571379"}}