title: First clinical experience with beta-trace protein (prostaglandin D synthase) as a marker for perilymphatic fistula.
abstract: A diagnosis of perilymphatic fistula is still controversial. Recently, a case report indicated that beta-trace protein (prostaglandin D synthase) might be a potential marker for perilymphatic fluid. In this multicentre clinical case series study beta-trace protein was used as a marker for perilymphatic fluid fistula. Fifteen fluid samples were collected during diagnostic tympanoscopy. In addition, five samples were collected from patients with tympanic membrane perforation for use as as negative controls. Samples were obtained using precision glass capillaries and were analysed for beta-trace protein using laser nephelometry. The diagnosis of perilymphatic fistula was defined by the patient's history, the audiological and vestibular investigation and the findings at tympanoscopy. The cut-off level of beta-trace protein for perilymph-positive samples was chosen at 1.11 mg/l. The sensitivity and specificity were calculated using a 2 x 2 contingency table. There was no false positive result, but in two cases a false negative result was found. The specificity was 1 and the sensitivity was 0.81. The material of this first clinical study is small owing to the rarity of patients undergoing diagnostic tympanoscopy for perilymphatic fluid fistula. However, according to these preliminary results beta-trace protein might be a promising marker in the diagnosis of perilymphatic fluid fistulas.
authors.affiliation: Departments of Otorhinolaryngology and Neurology, University Medical School Cologne, Cologne, Germany.
authors.forename: Olaf
authors.initials: O
authors.lastname: Michel
authors.forename: Hela
authors.initials: H
authors.lastname: Petereit
authors.forename: Eckart
authors.initials: E
authors.lastname: Klemm
authors.forename: Leif Erik
authors.initials: LE
authors.lastname: Walther
authors.forename: Gregor
authors.initials: G
authors.lastname: Bachmann-Harildstad
mesh_terms: D015415:Biomarkers / Q000032:analysis; D004796:Clinical Enzyme Tests; D004812:Epidemiologic Methods; D005402:Fistula / Q000175:diagnosis*; D003639:Hearing Loss, Sudden / Q000209:etiology; D006801:Humans; D019746:Intramolecular Oxidoreductases / Q000032:analysis*; D007759:Labyrinth Diseases / Q000150:complications / Q000175:diagnosis*; D054834:Lipocalins; D009391:Nephelometry and Turbidimetry / Q000379:methods; D010498:Perilymph / Q000201:enzymology*; D014432:Tympanic Membrane
chemical_list: D015415:Biomarkers; D054834:Lipocalins; D019746:Intramolecular Oxidoreductases; C022466:prostaglandin R2 D-isomerase