Traces of perilymph detected in epipharyngeal fluid: perilymphatic fistulaas a cause of sudden hearing loss diagnosed with beta-trace protein (prostaglandin D synthase) immunoelectrophoresis

The incidence of perilymphatic fistula as cause of sudden hearing loss is n ot known. We present a case with sudden unilateral hearing loss associated with a positive beta -trace protein test of an epipharyngeal fluid sample. The patient presented with sudden sensorineural hearing loss on the right s ide. A stapedotomy had been performed nine months previously due to otoscle rosis. Intravenous therapy for the treatment of sudden hearing loss was uns uccessful. At the time of sudden hearing loss, epipharyngeal fluid was coll ected using a Raucocel sinus pack. Investigation using rocket immunoelectro phoresis showed the presence of beta -trace protein. Upon repeating tympano scopy there was no obvious labyrinthine fluid egress, but the oval window w as sealed with fibrin sponge and fibrin glue. The patient's hearing improve d over a period of five months.