在伴有气压伤前驱史的Cochlin-tomoprotein确诊外淋巴瘘中出现爆裂声和流水样耳鸣
Popping sound and streaming water-like tinnitus in Cochlin-tomoprotein-confirmed perilymphatic fistula with antecedent barotrauma.
文献信息
| PMID | 42723732 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Yukihide Maeda |
| 作者单位 | Department of Otorhinolaryngology, Saitama Medical University, Iruma-gun, Saitama-Ken, Japan. |
| 期刊 | Frontiers in neurology |
| SCI 分区 | Q2 |
| IF | 3.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 气压伤后的外淋巴瘘（PLF）与爆裂声、流水样耳鸣及瘘管征有关，但客观证据有限。
目的/目标： 确定这些特征是否与气压伤前驱史后经Cochlin-tomoprotein（CTP）确诊的PLF相关。
材料与方法： 我们回顾性分析了在日本80家机构接受CTP检测的736例患者中的149例2类（外部气压伤）或3类（内部压力相关气压伤）病例。使用Fisher精确检验按CTP状态比较临床特征的发生频率。
结果： CTP阳性率在2类中为17%，在3类中为22%。在2类中，有爆裂声的患者CTP阳性率高于无爆裂声者（60% vs. 12%；OR，10.88；95% CI，1.63-68.66；p = 0.035）。在3类中，有流水样耳鸣的患者CTP阳性率高于无流水样耳鸣者（41% vs. 16%；OR，3.75；95% CI，1.30-10.31；p = 0.019），有眼球震颤的患者CTP阳性率高于无眼球震颤者（30% vs. 12%；OR，3.12；95% CI，1.18-8.70；p = 0.033）。瘘管征与CTP阳性无关。
结论与意义： 在CTP确诊的PLF中，症状特征因气压伤机制而异。爆裂声可能是提示外部气压伤后PLF的特征性临床线索，而流水样耳鸣和眼球震颤可能更好地提示内部压力相关事件后的PLF，尽管本研究中观察到的关联为探索性且未进行多重比较校正。瘘管征缺失不应排除PLF。
英文摘要
BACKGROUND: Perilymphatic fistula (PLF) after barotrauma has been linked to popping sounds, streaming water-like tinnitus, and fistula signs, but objective evidence is limited.
AIMS/OBJECTIVES: To determine whether these features are associated with Cochlin-tomoprotein (CTP)-confirmed PLF after antecedent barotrauma.
MATERIALS AND METHODS: 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's exact test.
RESULTS: 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, 1.63-68.66; p = 0.035). 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, 1.30-10.31; p = 0.019) and in patients with nystagmus than in those without it (30% vs. 12%; OR, 3.12; 95% CI, 1.18-8.70; p = 0.033). Fistula signs were not associated with CTP positivity.
CONCLUSIONS AND SIGNIFICANCE: 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.