Rapid protein test for perilymph fistula

Area of Science:

• Otolaryngology
• Neurosurgery
• Audiology

Background:

• Perilymph fistula diagnosis is often difficult, especially in non-obvious cases.
• Spontaneous perilymph fistulas are considered rare by many surgeons, often linked to trauma or pressure changes.
• Accurate diagnosis is crucial for appropriate patient management.

Purpose of the Study:

• To evaluate the utility of middle ear fluid protein analysis for diagnosing perilymph fistula.
• To establish a reliable method for confirming or excluding perilymph fistula presence.
• To potentially reduce negative middle ear explorations.

Main Methods:

• Fluid samples collected from the oval and round window niches via micropipets after myringotomy or tympanotomy.
• Analysis of protein concentration using rapid protein indicator paper, comparing color changes to known standards.
• Original technique adapted from diagnostic labyrinthotomy procedures used for acoustic neuroma suspects.

Main Results:

• Normal perilymph protein content is approximately 200 mg%, indicated by light green on indicator paper.
• Serum or transudate protein content is around 7000 mg%, indicated by dark green.
• Protein analysis provides objective data to support or refute perilymph fistula diagnosis.

Conclusions:

• Middle ear fluid protein analysis is a valuable tool for diagnosing perilymph fistula.
• This method can help avoid unnecessary surgical interventions for suspected perilymph fistula.
• The technique offers a reliable way to document the presence or absence of perilymph.