CTP (Cochlin-tomoprotein) detection in the profuse fluid leakage (gusher) from cochleostomy

• Published in: Acta oto-laryngologica Vol. 130; no. 8; pp. 881 - 887
• Main Authors: Ikezono, Tetsuo, Sugizaki, Kazuki, Shindo, Susumu, Sekiguchi, Satomi, Pawankar, Ruby, Baba, Shunkichi, Yagi, Toshiaki
• Format: Journal Article
• Language: English
• Published: Stockholm Informa UK Ltd 01.08.2010; Taylor & Francis; Informa
• Subjects: Biological and medical sciences; branchio-oto-renal syndrome; Branchio-Oto-Renal Syndrome - metabolism; Branchio-Oto-Renal Syndrome - surgery; Cerebrospinal Fluid - metabolism; COCH gene; Cochlea - surgery; cochlear implant; Cochlear Implantation; Cochlin isoform; CSF; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Extracellular Matrix Proteins; Humans; Male; Medical sciences; Middle Aged; Non tumoral diseases; Otorhinolaryngology. Stomatology; Perilymph; Perilymph - metabolism; Proteins - metabolism; sensorineural hearing loss; sensorineural hearing loss; branchio-oto-renal syndrome; Urinary system disease; Melnick Fraser syndrome; Cochlin isoform; Internal ear disease; Diseases of the osteoarticular system; Auditory disorder; ENT; Cerebrospinal fluid; COCH gene; Gene; CSF; Cochlear implant; ENT disease; Perception hearing loss; Perilymph; Complex syndrome; Sensory hearing loss
• ISSN: 0001-6489; 1651-2251
• DOI: 10.3109/00016480903508910

Abstract Conclusions: By testing 125 samples, we confirmed that Cochlin-tomoprotein (CTP) is present in the perilymph, not in cerebrospinal fluid (CSF). Perilymph and CSF exist in two distinct compartments, even in the case of a malformed inner ear with a bony defect in the lamina cribrosa, as described here. Cochleostomy might have suddenly decreased the perilymph pressure, allowing the influx of CSF into the inner ear resulting in profuse fluid leakage, first perilymph then CSF. Objectives: The first purpose of this study was to further confirm the specificity of the perilymph-specific protein CTP that we reported recently. Secondly, we assessed the nature of the fluid leakage from the cochleostomy using the CTP detection test. Methods: A standardized CTP detection test was performed on 65 perilymph and 60 CSF samples. Samples of profuse fluid leakage collected from cochleostomy during cochlear implantation surgery of one patient with branchio-oto-renal (BOR) syndrome were also tested by the CTP detection test. Results: CTP was detected in 60 of 65 perilymph samples but not in any of the CSF samples. The leaked fluid was shown to contain CTP, i.e. perilymph, at the outset, and then the CTP detection signals gradually disappeared as time elapsed.