Cochlin-tomoprotein (CTP) detection test identifies traumatic perilymphatic fistula due to penetrating middle ear injury

• Published in: Acta oto-laryngologica Vol. 131; no. 9; pp. 937 - 944
• Main Authors: Ikezono, Tetsuo, Shindo, Susumu, Sekine, Kuwon, Shiiba, Kyoko, Matsuda, Han, Kusama, Kaoru, Koizumi, Yasuo, Sugizaki, Kazuki, Sekiguchi, Satomi, Kataoka, Ryohei, Pawankar, Ruby, Baba, Shunkichi, Yagi, Toshiaki, Okubo, Kimihiro
• Format: Journal Article
• Language: English
• Published: Stockholm Informa Healthcare 01.09.2011; Taylor & Francis; Informa
• Subjects: Adult; Audiometry, Pure-Tone; Biological and medical sciences; Biomarkers - analysis; Blotting, Western; Bone Conduction; Child; COCH gene; cochlin isoform; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Ear, Middle - injuries; Extracellular Matrix Proteins - analysis; Female; Fistula - diagnosis; Follow-Up Studies; hearing loss; Hearing Loss, Conductive - diagnosis; Hearing Loss, Conductive - etiology; Humans; Image Processing, Computer-Assisted; Labyrinth Diseases - diagnosis; Male; Medical sciences; Middle Aged; Middle ear trauma; Non tumoral diseases; Otorhinolaryngology. Stomatology; Perilymph - chemistry; Perilymph - physiology; Predictive Value of Tests; Protein Isoforms - analysis; Proteomics; Tomography, X-Ray Computed; Tympanic Membrane Perforation - diagnosis; Vertigo - diagnosis; Vertigo - etiology; Wounds, Penetrating - diagnosis; cochlin isoform; COCH gene; Gene; Penetrating injury; Perilymph fistula; Auditory disorder; ENT disease; Middle ear trauma; ENT; Middle ear; Trauma; Hearing loss
• ISSN: 0001-6489; 1651-2251
• DOI: 10.3109/00016489.2011.575795

Abstract Conclusions: The cochlin-tomoprotein (CTP) detection test can be used to make a definite, objective diagnosis of traumatic perilymphatic fistula (PLF), and therefore offers valuable information on patient selection for surgical treatment. Objectives: Penetrating middle ear injury can cause traumatic PLF, which is a surgically treatable otologic emergency. Recently, we have reported on CTP, a novel perilymph-specific protein. The purpose of this study was to determine if the CTP detection test is useful for the diagnosis of traumatic PLF. Methods: This was a prospective study of CTP detection in penetrating middle ear injury cases with tympanic membrane perforation and hearing loss. Results: A total of seven individuals were included in this study. CTP was detected in three of four cases with posterosuperior quadrant perforation of the tympanic membrane. In one of these three cases, even though the high resolution CT scan was not suggestive of PLF and the perilymph leakage could not be visualized intraoperatively, the CTP detection test was able to detect PLF. In two cases, the preoperative positive test results enabled us to make a diagnosis of PLF and a decision for surgical treatment. CTP was not detected in the cases with anterior or inferior tympanic membrane perforation.