{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:18:10Z","timestamp":1787807890228,"version":"build-2784847793"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"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>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Perilymphatic fistula (PLF) after barotrauma has been linked to popping sounds, streaming water-like tinnitus, and fistula signs, but objective evidence is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims\/objectives<\/jats:title>\n                    <jats:p>To determine whether these features are associated with Cochlin-tomoprotein (CTP)-confirmed PLF after antecedent barotrauma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 149 category 2 (external barotrauma) or category 3 (internal pressure-related barotrauma) cases among 736 patients who underwent CTP testing at 80 Japanese institutions. Frequencies of clinical features were compared by CTP status using Fisher\u2019s exact test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CTP positivity was 17% in category 2 and 22% in category 3. In category 2, CTP positivity was higher in patients with a popping sound than in those without it (60% vs. 12%; OR, 10.88; 95% CI, 1.63\u201368.66;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.035). In category 3, CTP positivity was higher in patients with streaming water-like tinnitus than in those without it (41% vs. 16%; OR, 3.75; 95% CI, 1.30\u201310.31;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.019) and in patients with nystagmus than in those without it (30% vs. 12%; OR, 3.12; 95% CI, 1.18\u20138.70;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.033). Fistula signs were not associated with CTP positivity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and significance<\/jats:title>\n                    <jats:p>Symptom profiles differed by barotraumatic mechanism in CTP-confirmed PLF. A popping sound may represent a characteristic clinical clue suggestive of PLF after external barotrauma, whereas streaming water-like tinnitus and nystagmus may better indicate PLF after internal pressure-related events, although the observed associations in this study were exploratory and not adjusted for multiple comparisons. Absence of a fistula sign should not exclude PLF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1939108","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T04:26:21Z","timestamp":1787804781000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Popping sound and streaming water-like tinnitus in Cochlin-tomoprotein-confirmed perilymphatic fistula with antecedent barotrauma"],"prefix":"10.3389","volume":"17","author":[{"given":"Yukihide","family":"Maeda","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Saitama Medical University","place":["Iruma-gun, Saitama-Ken, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Saitama Medical University","place":["Iruma-gun, Saitama-Ken, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyasu","family":"Kitahara","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Saitama Medical University","place":["Iruma-gun, Saitama-Ken, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masafumi","family":"Sawada","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Saitama Medical University","place":["Iruma-gun, Saitama-Ken, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuichiro","family":"Araki","sequence":"additional","affiliation":[{"name":"Medical Education Center, Saitama Medical University","place":["Iruma-gun, Saitama-Ken, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroe","family":"Kudo","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Saitama Medical University","place":["Iruma-gun, Saitama-Ken, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Saitama Medical University","place":["Iruma-gun, Saitama-Ken, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuya","family":"Takayama","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Saitama Medical University","place":["Iruma-gun, Saitama-Ken, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuo","family":"Ikezono","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Saitama Medical University","place":["Iruma-gun, Saitama-Ken, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"ref1","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":"ref2","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1177\/000348940111000507","article-title":"Perilymphatic fistula and Meniere\u2019s disease. 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